Registration
malaria, infectious diseases, malarial anaemia
MALARIA, INFECTIOUS DISEASES
ClinicalTrials.gov NCT02694055.Ensuring that all people have access to quality health services without financial hardship is central to achieving universal health coverage (UHC) and other health-related targets of the Sustainable Development Goal (SDGs). Despite progress to date, up to one-third of the world’s population may not benefit from UHC by 2030 [Community health workers (CHWs) have the potential to contribute to the diverse, sustainable health workforce required to deliver integrated, people-centred primary care [However, iCCM programme design and implementation vary greatly between settings, to variable effects [Optimising iCCM means moving beyond training and deploying CHWs to ensure that these frontline health workers are integrated into and adequately supported by the health system [Across sub-Saharan Africa, including in Mali, CHWs are stationed in community health sites to provide iCCM and other community-based services to patients who seek care. An alternative to this conventional, passive approach to service delivery is a proactive workflow in which CHWs conduct routine door-to-door home visits, searching for and identifying prospective patients. Proactively offering promotive, preventive, and curative services at patients’ doorsteps may improve community engagement, service coverage, and treatment outcomes, and especially the speed with which evaluation and treatment are received.Ensuring prompt treatment, particularly within the crucial 24-hour window after symptom onset in children under five, is a cornerstone of global iCCM and malaria control programmes. A meta-analysis estimated that almost half of severe childhood malarial anaemia cases in the included studies could have been averted if children had accessed facility-based treatment within the first day of symptom onset [Based on existing evidence, it is uncertain whether proactive case-finding home visits by CHWs can improve prompt treatment and reduce the prevalence of infectious diseases or under-five mortality [