02580nas a2200169   4500000000100000008004100001260003400042653001800076100001300094700001000107700001300117700001100130245009800141856010400239520205300343022001402396       2022                            d  bOxford University Press (OUP)10aHealth Policy1 aWerner K1 aKak M1 aHerbst C1 aLin TK00aThe role of community health worker-based care in post-conflict settings: a systematic review  uhttps://academic.oup.com/heapol/advance-article-pdf/doi/10.1093/heapol/czac072/45910904/czac072.pdf3 a<p>Countries affected by conflict often experience the deterioration of health system infrastructure and weakened service delivery. Evidence suggests that healthcare services that leverage local community dynamics may ameliorate health system-related challenges, however, little is known about implementing these interventions in contexts where formal delivery of care is hampered subsequent to conflict. We reviewed the evidence on community health worker (CHW)-delivered healthcare in conflict-affected settings and synthesized reported information on the effectiveness of interventions and characteristics of care delivery. We conducted a systematic review of studies in OVID MedLine, Web of Science, Embase, Scopus, CINHAL, and Google Scholar databases. Included studies (1) described a context that is post-conflict, conflict-affected, or impacted by war or crisis; (2) examined the delivery of healthcare by CHWs in the community; (3) reported a specific outcome connected to CHWs or community-based healthcare (CBHC); (4) were available in English, Spanish, or French; and (5) were published between 1 January 2000 and 6 May 2021. We identified 1976 articles, of which 55 met the inclusion criteria. Nineteen countries were represented, and five categories of disease were assessed. Evidence suggests that CHW interventions not only may be effective but also efficient in circumventing the barriers associated with access to care in conflict-affected areas. CHWs may leverage their physical proximity and social connection to the community they serve to improve care by facilitating access to care, strengthening disease detection, and improving adherence to care. Specifically, case management (e.g. integrated community case management) were was documented to be effective in improving a wide range of health outcomes and should be considered as a strategy to reduce barrier to access in hard-to-reach areas. Furthermore, task-sharing strategies have been emphasized as a common mechanism for incorporating CHWs into health systems</p>
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