The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties.
COVID-19 and other pandemics remain significant threats to population health, particularly in rural settings where health systems are disproportionately weak. There is a lack of evidence on whether trained, equipped, and deployed community health workers (CHWs) can lead to significant reductions in...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2024-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0003036&type=printable |
| _version_ | 1827302549357592576 |
|---|---|
| author | Neema Kaseje Kennedy Oruenjo Dan Kaseje Meghna Ranganathan Marcel Tanner Andy Haines |
| author_facet | Neema Kaseje Kennedy Oruenjo Dan Kaseje Meghna Ranganathan Marcel Tanner Andy Haines |
| author_sort | Neema Kaseje |
| collection | DOAJ |
| description | COVID-19 and other pandemics remain significant threats to population health, particularly in rural settings where health systems are disproportionately weak. There is a lack of evidence on whether trained, equipped, and deployed community health workers (CHWs) can lead to significant reductions in COVID-19 infections and deaths. Our objective was to measure the effectiveness of deploying trained and equipped CHWs in reducing COVID-19 infections and deaths by comparing outcomes in two counties in rural Western Kenya, a setting with limited critical care capacity and limited access to COVID-19 vaccines and oral COVID-19 antivirals. In Siaya, trained CHWs equipped with thermometers, pulse oximeters, and KN95 masks, visited households to convey health information about COVID-19 prevention. They screened, isolated, and referred COVID-19 cases to facilities with oxygen capacity. They measured and digitally recorded vital signs at the household level. In Kisii county, the standard Kenya national COVID-19 protocol was implemented. We performed a comparative analysis of differences in CHW skills, activity, and COVID-19 infections and deaths using district health information system (DHIS2) data. Trained Siaya CHWs were more skilled in using pulse oximeters and digitally reporting vital signs at the household level. The mean number of oxygen saturation measurements conducted in Siaya was 24.19 per COVID-19 infection; and the mean number of temperature measurements per COVID-19 infection was 17.08. Siaya CHWs conducted significantly more household visits than Kisii CHWs (the mean monthly CHW household visits in Siaya was 146,648.5, standard deviation 11,066.5 versus 42,644.5 in Kisii, standard deviation 899.5, p value = 0.01). Deploying trained and equipped CHWs in rural Western Kenya was associated with lower risk ratios for COVID-19 infections and deaths: 0.54, 95% CI [0.48-0.61] and 0.29, CI [0.13-0.65], respectively, consistent with a beneficial effect. |
| first_indexed | 2024-04-24T16:47:10Z |
| format | Article |
| id | doaj.art-43e64d607a9d4183bf2c1aa9490eadf5 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-04-24T16:47:10Z |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-43e64d607a9d4183bf2c1aa9490eadf52024-03-29T06:02:11ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752024-01-0143e000303610.1371/journal.pgph.0003036The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties.Neema KasejeKennedy OruenjoDan KasejeMeghna RanganathanMarcel TannerAndy HainesCOVID-19 and other pandemics remain significant threats to population health, particularly in rural settings where health systems are disproportionately weak. There is a lack of evidence on whether trained, equipped, and deployed community health workers (CHWs) can lead to significant reductions in COVID-19 infections and deaths. Our objective was to measure the effectiveness of deploying trained and equipped CHWs in reducing COVID-19 infections and deaths by comparing outcomes in two counties in rural Western Kenya, a setting with limited critical care capacity and limited access to COVID-19 vaccines and oral COVID-19 antivirals. In Siaya, trained CHWs equipped with thermometers, pulse oximeters, and KN95 masks, visited households to convey health information about COVID-19 prevention. They screened, isolated, and referred COVID-19 cases to facilities with oxygen capacity. They measured and digitally recorded vital signs at the household level. In Kisii county, the standard Kenya national COVID-19 protocol was implemented. We performed a comparative analysis of differences in CHW skills, activity, and COVID-19 infections and deaths using district health information system (DHIS2) data. Trained Siaya CHWs were more skilled in using pulse oximeters and digitally reporting vital signs at the household level. The mean number of oxygen saturation measurements conducted in Siaya was 24.19 per COVID-19 infection; and the mean number of temperature measurements per COVID-19 infection was 17.08. Siaya CHWs conducted significantly more household visits than Kisii CHWs (the mean monthly CHW household visits in Siaya was 146,648.5, standard deviation 11,066.5 versus 42,644.5 in Kisii, standard deviation 899.5, p value = 0.01). Deploying trained and equipped CHWs in rural Western Kenya was associated with lower risk ratios for COVID-19 infections and deaths: 0.54, 95% CI [0.48-0.61] and 0.29, CI [0.13-0.65], respectively, consistent with a beneficial effect.https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0003036&type=printable |
| spellingShingle | Neema Kaseje Kennedy Oruenjo Dan Kaseje Meghna Ranganathan Marcel Tanner Andy Haines The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties. PLOS Global Public Health |
| title | The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties. |
| title_full | The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties. |
| title_fullStr | The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties. |
| title_full_unstemmed | The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties. |
| title_short | The effectiveness of community health worker training, equipping, and deployment in reducing COVID-19 infections and deaths in rural Western Kenya: A comparison of two counties. |
| title_sort | effectiveness of community health worker training equipping and deployment in reducing covid 19 infections and deaths in rural western kenya a comparison of two counties |
| url | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0003036&type=printable |
| work_keys_str_mv | AT neemakaseje theeffectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT kennedyoruenjo theeffectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT dankaseje theeffectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT meghnaranganathan theeffectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT marceltanner theeffectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT andyhaines theeffectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT neemakaseje effectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT kennedyoruenjo effectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT dankaseje effectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT meghnaranganathan effectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT marceltanner effectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties AT andyhaines effectivenessofcommunityhealthworkertrainingequippinganddeploymentinreducingcovid19infectionsanddeathsinruralwesternkenyaacomparisonoftwocounties |