Evidence map›Paper›PMID 41834041›Full record

ArticleConflict and health2026

A village health worker intervention to reduce cardiovascular disease risk in remote areas of armed conflict in Myanmar-results from a feasibility study in three villages.

Anu Ramachandran, Su Mon Thwe, Cho Zin Win, Nay Lynn Htet, Saw Kyaw Myint, Nan Ei Mon Myint, Nicholus Tint Zaw, Ravi Goyal, Zin Mar Win, Zay Yar Phyo Aung and 3 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Conflict and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06819839 (Impact of a Community Health Worker Care Model to Reduce Cardiovascular Disease Risk Among Conflict-affected Populations in Eastern Myanmar), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

NCT06819839 nacompletednot on this map

Impact of a Community Health Worker Care Model to Reduce Cardiovascular Disease Risk Among Conflict-affected Populations in Eastern Myanmar: a Cluster Randomized Controlled Trial (cRCT)

TypeinterventionalSponsorCommunity Partners InternationalRan2024 to 2025Enrolled213ConditionsCardiovascular Diseases, Hypertension, DiabetesArmsVillage Health Worker (VHW) Care Model
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

13 authors.

Anu RamachandranCenter for Innovation to Implementation, VA Palo Alto, Palo Alto, CA, USA. anu.ramachandran@ucsf.edu.ORCID http://orcid.org/0009-0002-6413-9493
Su Mon ThweOrganization name withheld for security reasons, Berkeley, CA, USA.ORCID http://orcid.org/0000-0002-0397-0534
Cho Zin WinOrganization name withheld for security reasons, Chiang Mai, Thailand.
Nay Lynn HtetOrganization name withheld for security reasons, Berkeley, CA, USA.
Saw Kyaw MyintKaren Department of Health and Welfare, Klo Yaw Lay, Karen State, Myanmar.
Nan Ei Mon MyintOrganization name withheld for security reasons, Berkeley, CA, USA.ORCID http://orcid.org/0000-0001-8054-9543
Nicholus Tint ZawOrganization name withheld for security reasons, Berkeley, CA, USA.
Ravi GoyalUniversity of California, San Diego, CA, USA.ORCID http://orcid.org/0000-0002-0358-2435
Zin Mar WinOrganization name withheld for security reasons, Berkeley, CA, USA.ORCID http://orcid.org/0000-0002-2571-0135
Zay Yar Phyo AungOrganization name withheld for security reasons, Berkeley, CA, USA.ORCID http://orcid.org/0000-0002-8002-2458
Tom TraillOrganization name withheld for security reasons, Berkeley, CA, USA.ORCID http://orcid.org/0000-0002-0684-834X
Adam Kimball RichardsCenter for Humanitarian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.ORCID http://orcid.org/0000-0002-7098-0513
Parveen ParmarDepartment of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, United States.ORCID http://orcid.org/0000-0002-2447-6690

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular disease (CVD) is a leading cause of death in low-income countries and those affected by armed conflict, including Myanmar. Community health worker interventions can effectively address CVD risk factors in low-income countries but have not been tested among displaced populations in active conflict zones.

objectivesWe conducted a feasibility study of a village health worker (VHW) care model to identify individuals at high CVD risk and deliver care in conflict-affected regions of Karen State, Myanmar. This study was conducted by an international non-governmental organization collaborating with a regional local health organization.

methodsFollowing a village census, trained VHWs and medics screened individuals age ≥ 40 for CVD risk factors in three villages. Eligible individuals had HTN, diabetes, calculated CVD risk > 10%, or history of heart attack or stroke, confirmed during a second visit 1-2 weeks later. VHWs visited households every 3-6 weeks for 2 months to monitor blood pressure, glucose, medication adherence/side effects, and deliver medic-prescribed medications. Feasibility evaluation centered on reach, adoption, and acceptability. Outcomes included CVD risk factor prevalence, recruitment and retention, medication initiation/adherence, changes in hypertension control, and adverse outcomes. VHW and medic focus group discussions and study participant interviews were conducted.

resultsCVD teams screened 294 individuals, conducted confirmatory visits with 132, enrolled all 97 eligible participants, and completed two home visits with 94 patients. Several prescription errors were made, halting medication initiation; root cause analysis identified opportunities to improve pre-testing of electronic tools and strengthen clinician CVD training. The proportion of eligible participants receiving antihypertensive or statin medications increased from 23% to 56%. Among those with HTN, the proportion achieving blood pressure control < 140/90 mmHg increased from 22.9% to 65.7%. Qualitative assessment revealed support for the care model and opportunities to improve training and streamline clinical protocols.

conclusionsOur study suggests a VHW care model for CVD in remote villages in Myanmar experiencing armed conflict is feasible and can increase medication access. Opportunities exist to simplify CVD treatment guidelines and augment training and support of local providers. Findings informed a cluster randomized controlled trial to test the impact of a modified VHW care model on medication adherence, CVD risk, and cost.

trial registrationClinicalTrials.gov, NCT06819839, retrospectively registered 27 October 2024.

Indexed as

Armed conflictCardiovascular diseaseCommunity health workerFeasibility studyMyanmar

Identifiers

PMID41834041
PMCPMC13104435

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Registered trials

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.