Community Health Workers in Diabetes Prevention and Management in Developing Countries

• Main Authors: Halimatou Alaofè, Ibitola Asaolu, Jennifer Ehiri, Hayley Moretz, Chisom Asuzu, Mobolanle Balogun, Olayinka Abosede, John Ehiri
• Format: Article
• Language: English
• Published: Levy Library Press 2017-11-01
• Series: Annals of Global Health
• Subjects: community health worker; diabetes; diabetes management; diabetes prevention; low-and middle-income countries
• Online Access: https://annalsofglobalhealth.org/articles/199

<p>Background</p><p>There is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of <a title="Learn more about Diabetes mellitus type 2" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes-mellitus-type-2">type 2 diabetes mellitus</a> (T2DM) in LMICs.</p><p>Methods</p><p>To identify studies that reported the effect of CHW interventions for prevention and management of <a title="Learn more about Diabetes mellitus type 2" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes-mellitus-type-2">T2DM</a> in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane <a title="Learn more about Metabolic Disorder" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/metabolic-disease">Metabolic and Endocrine Disorders</a> Group's Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017.</p><p>Findings</p><p>Ten studies were included (4 pre- and post-studies, 2 <a title="Learn more about Randomized Controlled Trial" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/randomized-controlled-trial">randomized controlled trials</a>, 2 <a title="Learn more about Cohort Study" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cohort-study">cohort studies</a>, 1 <a title="Learn more about Cross Sectional Study" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cross-sectional-study">cross-sectional study</a>, and 1 case-control study). The role of CHWs consisted of patient education, identification and referral of high-risk individuals to physicians, and provision of <a title="Learn more about Social support" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/social-support">social support</a> through home visits. Positive outcomes were reported in 7 of 10 studies. These outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased <a title="Learn more about Medication Adherence" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/medication-adherence">medication adherence</a>; and improved fasting blood sugar, <a title="Learn more about Glycated hemoglobin" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/glycated-hemoglobin">glycated hemoglobin</a>, and <a title="Learn more about Body mass index" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/body-mass-index">body mass index</a>. Three studies showed no significant outcomes.</p><p>Conclusions</p>CHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. Given the limited number of studies included in this review, robust conclusions cannot be drawn at the present time.