Evidence map›Paper›PMID 36151553›Full record

ArticleBMC health services research2022

Assessing community health workers' time allocation for a cervical cancer screening and treatment intervention in Malawi: a time and motion study.

Jobiba Chinkhumba, Dorothy Low, Evelyn Ziphondo, Lizzie Msowoya, Darcy Rao, Jennifer S Smith, Erik Schouten, Victor Mwapasa, Luis Gadama, Ruanne Barnabas and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% of its field
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

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

  1. Pooled it
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  3. Article
  4. 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

12 authors at 5 institutions in 2 countries.

Jobiba ChinkhumbaDepartment of Health Systems and Policy, Kamuzu University of Health Sciences, Blantyre, Malawi. jchinkhumba@kuhes.ac.mw.
Dorothy LowDepartment of Global Health, University of Washington, Seattle, USA.
Evelyn ZiphondoUNC Project, Lilongwe, Malawi.
Lizzie MsowoyaUNC Project, Lilongwe, Malawi.
Darcy RaoDepartment of Epidemiology, University of Washington, Seattle, USA.
Jennifer S SmithUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Erik SchoutenUNC Project, Lilongwe, Malawi.
Victor MwapasaDepartment of Health Systems and Policy, Kamuzu University of Health Sciences, Blantyre, Malawi.
Luis GadamaDepartment of Health Systems and Policy, Kamuzu University of Health Sciences, Blantyre, Malawi.
Ruanne BarnabasDivision of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.
Lameck ChinulaUNC Project, Lilongwe, Malawi.
Jennifer H TangUNC Project, Lilongwe, Malawi.
University of North Carolina at Chapel Hill · USKamuzu Central Hospital · MWUniversity of Washington · USKamuzu University of Health SciencesMassachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCommunity health workers (CHWs) are essential field-based personnel and increasingly used to deliver priority interventions to achieve universal health coverage. Existing literature allude to the potential for detrimental effects of multi-tasking CHWs. This study objective was to assess the impact of integrating cervical cancer screening and prevention therapy (CCSPT) with family planning (FP) on time utilization among CHWs.

methodsA time and motion study was conducted in 7 health facilities in Malawi. Data was collected at baseline between October-July 2019, and 12 months after CCSPT implementation between July and August 2021. CHWs trained to deliver CCSPT were continuously observed in real time while their activities were timed by independent observers. We used paired sample t-test to assess pre-post differences in average hours CHWs spent on the following key activities, before and after CCSPT implementation: clinical and preventive care; administration; FP; and non-work-related tasks. Regression models were used to ascertain impact of CCSPT on average durations CHWs spent on key activities.

resultsThirty-seven (n = 37) CHWs were observed. Their mean age and years of experience were 42 and 17, respectively. Overall, CHWs were observed for 323 hours (inter quartile range: 2.8-5.5). Compared with the period before CCSPT, the proportion of hours CHWs spent on clinical and preventive care, administration and non-work-related activities were reduced by 13.7, 8.7 and 34.6%, respectively. CHWs spent 75% more time on FP services after CCSPT integration relative to the period before CCSPT. The provision of CCSPT resulted in less time that CHWs devoted towards clinical and preventive care but this reduction was not significant. Following CCPST, CHWs spent significantly few hours on non-work-related activities.

conclusionIntroduction of CCSPT was not very detrimental to pre-existing community services. CHWs managed their time ensuring additional efforts required for CCSPT were not at the expense of essential activities. The programming and policy implications are that multi-tasking CHWs with CCSPT will not have substantial opportunity costs.

Indexed as

Community Health WorkersUterine Cervical NeoplasmsEarly Detection of CancerFemaleHumansMalawiTime and Motion StudiesCervical cancer screening and prevention therapyCommunity health workersTime and motion study

Identifiers

PMID36151553
PMCPMC9508781
OpenAlexW4296823920

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.