Journal article
The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature
- Abstract:
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Introduction: Community health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs.
Methods: We performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature.
Results: We identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss.
Conclusion: CHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 495.9KB, Terms of use)
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- Publisher copy:
- 10.1136/bmjgh-2018-001141
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- BMJ Global Health More from this journal
- Volume:
- 4
- Issue:
- 2
- Article number:
- e001141
- Publication date:
- 2019-03-01
- Acceptance date:
- 2019-01-25
- DOI:
- EISSN:
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2059-7908
- Pmid:
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30899572
- Language:
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English
- Keywords:
- Pubs id:
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pubs:982165
- UUID:
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uuid:72155961-6ade-46f8-b27b-402174632c66
- Local pid:
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pubs:982165
- Source identifiers:
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982165
- Deposit date:
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2019-04-16
Terms of use
- Copyright holder:
- O'Donovan et al.
- Copyright date:
- 2019
- Rights statement:
- © Authors. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license
- Licence:
- CC Attribution (CC BY)
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