Rce. This included the development of more formal cadres of Community

Rce. This included the development of more purchase Foretinib formal cadres of Community Health Workers (CHWs), defined as “members of, selected by, and answerable to the communities where they work; supported by the health system; and receiving less training than formally trained health workers” [7, 8]. In general, CHWs deliver low cost primary healthcare services to the communities they serve [9]. They are well situated to bridge the gap between communities and the healthcare system, and can facilitate engagement in care and overall continuity of care [9, 10]. CHW programs range from large-scale national programmes to smaller community-led initiatives [1, 11] and have led to improved access and coverage of health services in rural and remote areas in LMICs [11, 12]. Indeed the 2008 WHO report Primary Health care- Now More Than Ever, citing previous “failures and shortcomings” that have resulted in massive health inequities between and within countries, reinforced the important role of primary healthcare and CHWs in ensuring health for all [13] While communicable diseases like HIV/AIDS and Tuberculosis (TB) continue to exert a heavy toll in LMICs [14, 15], non-communicable diseases (NCDs) are also on the rise. An BMS-986020 chemical information estimated 639 million (625?54 million) hypertensive individuals now live in LMICs [16, 17]. In Kenya (population: 44.35 million [18]), NCDs increasingly account for a higher proportion of national morbidity and mortality [19, 20] and numerous people are now living with more than one chronic condition. For example, while people living with HIV (PLWH) represent approximately 7.1 of the adult Kenyan population, HIV/TB co-infection is estimated to affect 48 of all new TB patients [21] and hypertension among PLWH is estimated at 11.2 and 7.4 for men and women respectively [22]. As SART.S23506 a result of the rise in comorbidities, many settings, including Kenya, have begun to provide integrated chronic care [23?5]. Although there are differences in the etiology, treatment and prognosis across various diseases, in the case fpsyg.2017.00209 of HIV, TB and hypertension (HTN), all require regular engagement in the healthcare system for proper treatment and management. Linkage to formal care following a diagnosis is a critical for maximizing health outcomes, reducing morbidity and mortality, and in the case of communicable diseases like HIV and TB, minimizing the risk of forward transmission [26?1]. In part given that the number of physicians (0.18) and nurses/midwifes (0.79) per 1,000 Kenya is well below the recommended critical workforce [32], a national CHW program was launched in 2006 as part of a broader community health strategy. The goal of the CHW program is to ensure every household has access to primary care [11, 33]. Through proper training, CHWs can test for various illnesses and follow-up with individuals in their communities to ensure their conditions are being properly managed. This may occur at the household-level through routine follow-up or by ensuring individuals in communities are properly linked to the health facility where treatment and management is available [34]. Although CHWs are wellPLOS ONE | DOI:10.1371/journal.pone.0149412 February 22,2 /Perceptions of CHWs in Western Kenyasituated to encourage timely engagement in care and thus can play an important role in the management of various chronic conditions, it is unclear how they are perceived by the communities they serve. Negative perceptions of CHWs may impact their effectiveness at supporting linkage.Rce. This included the development of more formal cadres of Community Health Workers (CHWs), defined as “members of, selected by, and answerable to the communities where they work; supported by the health system; and receiving less training than formally trained health workers” [7, 8]. In general, CHWs deliver low cost primary healthcare services to the communities they serve [9]. They are well situated to bridge the gap between communities and the healthcare system, and can facilitate engagement in care and overall continuity of care [9, 10]. CHW programs range from large-scale national programmes to smaller community-led initiatives [1, 11] and have led to improved access and coverage of health services in rural and remote areas in LMICs [11, 12]. Indeed the 2008 WHO report Primary Health care- Now More Than Ever, citing previous “failures and shortcomings” that have resulted in massive health inequities between and within countries, reinforced the important role of primary healthcare and CHWs in ensuring health for all [13] While communicable diseases like HIV/AIDS and Tuberculosis (TB) continue to exert a heavy toll in LMICs [14, 15], non-communicable diseases (NCDs) are also on the rise. An estimated 639 million (625?54 million) hypertensive individuals now live in LMICs [16, 17]. In Kenya (population: 44.35 million [18]), NCDs increasingly account for a higher proportion of national morbidity and mortality [19, 20] and numerous people are now living with more than one chronic condition. For example, while people living with HIV (PLWH) represent approximately 7.1 of the adult Kenyan population, HIV/TB co-infection is estimated to affect 48 of all new TB patients [21] and hypertension among PLWH is estimated at 11.2 and 7.4 for men and women respectively [22]. As SART.S23506 a result of the rise in comorbidities, many settings, including Kenya, have begun to provide integrated chronic care [23?5]. Although there are differences in the etiology, treatment and prognosis across various diseases, in the case fpsyg.2017.00209 of HIV, TB and hypertension (HTN), all require regular engagement in the healthcare system for proper treatment and management. Linkage to formal care following a diagnosis is a critical for maximizing health outcomes, reducing morbidity and mortality, and in the case of communicable diseases like HIV and TB, minimizing the risk of forward transmission [26?1]. In part given that the number of physicians (0.18) and nurses/midwifes (0.79) per 1,000 Kenya is well below the recommended critical workforce [32], a national CHW program was launched in 2006 as part of a broader community health strategy. The goal of the CHW program is to ensure every household has access to primary care [11, 33]. Through proper training, CHWs can test for various illnesses and follow-up with individuals in their communities to ensure their conditions are being properly managed. This may occur at the household-level through routine follow-up or by ensuring individuals in communities are properly linked to the health facility where treatment and management is available [34]. Although CHWs are wellPLOS ONE | DOI:10.1371/journal.pone.0149412 February 22,2 /Perceptions of CHWs in Western Kenyasituated to encourage timely engagement in care and thus can play an important role in the management of various chronic conditions, it is unclear how they are perceived by the communities they serve. Negative perceptions of CHWs may impact their effectiveness at supporting linkage.

Leave a Reply