Evidence map›Paper›PMID 30637860›Full record

ArticleTropical medicine & international health : TM & IH2019

Provision of HIV services by community health workers should be strengthened to achieve full programme potential: a cross-sectional analysis in rural South Africa.

N Naidoo, N Matlakala, J Railton, S Khosa, G Marincowitz, J O Igumbor, J A McIntyre, H E Struthers, R P H Peters

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Tropical medicine & international health : TM & IH, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

N NaidooAnova Health Institute, Johannesburg and Tzaneen, South Africa.
N MatlakalaAnova Health Institute, Johannesburg and Tzaneen, South Africa.
J RailtonAnova Health Institute, Johannesburg and Tzaneen, South Africa.
S KhosaAnova Health Institute, Johannesburg and Tzaneen, South Africa.
G MarincowitzDepartment of Health, Mopani DCST, Giyani, Limpopo Province, South Africa.
J O IgumborSchool of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
J A McIntyreAnova Health Institute, Johannesburg and Tzaneen, South Africa.
H E StruthersAnova Health Institute, Johannesburg and Tzaneen, South Africa.
R P H PetersAnova Health Institute, Johannesburg and Tzaneen, South Africa.

Funding

Wits-UNC Partnership: Expanding Capacity in HIV Implementation Science in South AfricaD43TW009774 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI PETTIFOR, AUDREY, RAMASWAMY, ROHIT · 2014 to 2023
$3.0M
FIC NIH HHS D43 TW009774
6 · The paper itself

Abstract

objectiveSouth Africa's community health workers (CHWs) provide a bridge between the primary healthcare (PHC) facility and its community. We conducted a cross-sectional analysis to determine the contribution of the community-based HIV programme (CBHP) to the overall HIV programme.

methodsWe collected service provision data from the daily activity register of CHWs attached to 12 PHC facilities in rural Mopani District, South Africa. Personal identifiers of individuals referred to the facility for HIV services were recorded and verified against facility routine patient registers to determine the effectiveness of referral.

resultsHIV services were provided on 18 927 occasions; 30% of the total activities performed by CHWs during the study period. CHWs assessed 12 159 individuals for HIV risk (13% coverage of the study population); only 290 (2%) were referred for HIV testing services. Referral was effective in 213 (73%) individuals; evidence of an HIV-positive status was found for 38 (18%) individuals. However, 30 (79%) of these individuals were referred by CHWs despite being on ART. Adherence support was provided during 5657 visits; only one individual was referred for complications. Finally, of the 864 individuals lost to the ART programme, CHWs managed to find 452 (52%) for referral back to the facility; only 241 (53%) of these were (re)initiated on ART.

conclusionsProvision of HIV services by CHWs should be strengthened to fully deliver on the programme's potential. Human resource investment, home-based HIV testing and improved tracing models constitute potential strategies to enhance CHWs impact on the HIV programme.

Indexed as

Community Health ServicesCommunity Health WorkersProgram EvaluationRural Health ServicesRural PopulationAdolescentAdultAgedChildChild, PreschoolCross-Sectional StudiesDelivery of Health CareFemaleHIV InfectionsHome Care ServicesHumansagents de santé communautairescommunity health workershuman immunodeficiency virusprimary healthcaresoins de santé primairesvirus de l'immunodéficience humaine (VIH)

Identifiers

PMID30637860
PMCPMC6445684

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.