Harnessing the potentials of masters/mistresses of ceremony to promote community health and wellbeing amidst COVID-19 and other public health challenges.

Public health risk communication and general health information dissemination efforts require multiple approaches to sustainably engage communities to pursue individual and collective preventive actions. Engaging only highly skilled professionals to deliver public health messages, particularly in low and middle-income countries is expensive. Thus, masters/mistresses of ceremony (MCs) have the potential to contribute to disseminating evidence-based messages to communities on existing, emerging or re-emerging public health issues in developed and developing countries, thereby complementing existing dissemination efforts being made towards malaria, HIV/AIDS and SARS-CoV-2 (COVID-19) prevention and control, among others. Establishing feedback mechanisms to assess the impact of the MC-led health promotion on the target audiences is vital.

We need to start thinking about promoting the demand, uptake, and equitable distribution of COVID-19 vaccines NOW!

SARS-CoV-2 (COVID-19) is spreading rapidly within countries around the world, thus necessitating the World Health Organisation (WHO) to project that the peak of the pandemic has not been reached yet. Globally, COVID-19 public health control measures are being implemented; however, promising COVID-19 vaccine candidates are still in the early-stage clinical trials. Judging from previous vaccine programs around the world and the challenges encountered in the distribution and uptake, there seems to be no guarantee that there will be widespread acceptance and equitable distribution of the new COVID-19 vaccines when they are approved for use. Therefore, there is an urgent need to start engaging the public to allay their fears and misconceptions with the view to building trust and promoting acceptance and ultimately achieving a potential impact in controlling the pandemic. Borrowing from previously used successful public health strategies, including the application of the health belief model to engage communities, can go a long way in promoting the demand, uptake, and equitable distribution of the COVID-19 vaccine, thereby minimizing the likelihood of vaccine hesitancy.

Sexual and Reproductive Health Research and Research Capacity Strengthening in Africa: Perspectives from the region.

Developing the capacity to effectively carry out public health research is an integral part of health systems at both the national and global levels and strengthening research capacity is recognized as an approach to better health and development in low- and middle-income countries (LMICs). Especially fields such as sexual and reproductive health (SRH) would require inter-disciplinary teams of researchers equipped with a range of methodologies to achieve this. In November 2013, as part of the International Family Planning Conference in Addis Ababa, Ethiopia, a group of African researchers came together to discuss the gaps and strategies to improve sexual and reproductive health research and research capacity strengthening in Africa. This commentary summarizes the three broad areas where the issues and proposed solutions have concentrated around: 1) Addressing research gaps that are most relevant to policies and programmes in SRH, 2) Carrying out high quality and collaborative research, and 3) Translating research findings into SRH policies and programmes. Even though the focus of the discussions was Africa, the issues and proposed solutions can also be applied to other regions facing a high burden of disease with limited resources. The time is now and these can be achieved through synergistic commitment of African and global researchers, funders and organizations.

Developing culturally-oriented strategies for communicating women's health issues: a church-based intervention.

CONTEXT: In developing countries, messages on maternal health are often developed and conveyed without due regard to the literacy and cultural context of communities. Culturally-acceptable approaches are, however, necessary to increase awareness on womens health issues, especially in cultures where oral tradition is important. OBJECTIVE: To describe the processes adopted to engage church-based women support groups to develop innovative culturally-based strategies for communicating womens health matters. METHODS: We utilized an activity-oriented workgroup discussion methodology to engage 30 participants from 15 churches (two per church) in a two-day workshop located in an urban community in southeast Nigeria. The recruitment process included initial visits to 25 churches with an expression of interest form, followed by an invitation letter to the 15 churches that completed and returned the form. Participants were female church leaders, 26 years of age and older, from different occupations and educational levels. They attended a 16-hour (two-day) small group workshop, conducted in an adult-learning format. RESULTS: Six groups of five participants each used the Women and Health Learning Package (WHLP) to create and develop a dialogue on adolescent health, a drama on violence against women, a song on nutrition and womens health, a story on use of medicines by women, a quiz on cervical cancer and a poster on family planning. Thirteen of the 15 churches submitted a written report of the workshop to their local churches one month after the workshop as well as a copy to the workshop facilitator. Of the 13 churches, three organized a workshop to increase awareness on women s health issues in their local churches within three months of the workshop. CONCLUSION: Activity-oriented workshops can be a useful way of developing culturally- appropriate communication strategies for increasing awareness on womens health issues among church-based women groups.

Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases.

BACKGROUND: Lay health workers (LHWs) are widely used to provide care for a broad range of health issues. Little is known, however, about the effectiveness of LHW interventions. OBJECTIVES: To assess the effects of LHW interventions in primary and community health care on maternal and child health and the management of infectious diseases. SEARCH STRATEGY: For the current version of this review we searched The Cochrane Central Register of Controlled Trials (including citations uploaded from the EPOC and the CCRG registers) (The Cochrane Library 2009, Issue 1 Online) (searched 18 February 2009); MEDLINE, Ovid (1950 to February Week 1 2009) (searched 17 February 2009); MEDLINE In-Process & Other Non-Indexed Citations, Ovid (February 13 2009) (searched 17 February 2009); EMBASE, Ovid (1980 to 2009 Week 05) (searched 18 February 2009); AMED, Ovid (1985 to February 2009) (searched 19 February 2009); British Nursing Index and Archive, Ovid (1985 to February 2009) (searched 17 February 2009); CINAHL, Ebsco 1981 to present (searched 07 February 2010); POPLINE (searched 25 February 2009); WHOLIS (searched 16 April 2009); Science Citation Index and Social Sciences Citation Index (ISI Web of Science) (1975 to present) (searched 10 August 2006 and 10 February 2010). We also searched the reference lists of all included papers and relevant reviews, and contacted study authors and researchers in the field for additional papers. SELECTION CRITERIA: Randomised controlled trials of any intervention delivered by LHWs (paid or voluntary) in primary or community health care and intended to improve maternal or child health or the management of infectious diseases. A 'lay health worker' was defined as any health worker carrying out functions related to healthcare delivery, trained in some way in the context of the intervention, and having no formal professional or paraprofessional certificate or tertiary education degree. There were no restrictions on care recipients. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data using a standard form and assessed risk of bias. Studies that compared broadly similar types of interventions were grouped together. Where feasible, the study results were combined and an overall estimate of effect obtained. MAIN RESULTS: Eighty-two studies met the inclusion criteria. These showed considerable diversity in the targeted health issue and the aims, content, and outcomes of interventions. The majority were conducted in high income countries (n = 55) but many of these focused on low income and minority populations. The diversity of included studies limited meta-analysis to outcomes for four study groups. These analyses found evidence of moderate quality of the effectiveness of LHWs in promoting immunisation childhood uptake (RR 1.22, 95% CI 1.10 to 1.37; P = 0.0004); promoting initiation of breastfeeding (RR = 1.36, 95% CI 1.14 to 1.61; P < 0.00001), any breastfeeding (RR 1.24, 95% CI 1.10 to 1.39; P = 0.0004), and exclusive breastfeeding (RR 2.78, 95% CI 1.74 to 4.44; P <0.0001); and improving pulmonary TB cure rates (RR 1.22 (95% CI 1.13 to 1.31) P <0.0001), when compared to usual care. There was moderate quality evidence that LHW support had little or no effect on TB preventive treatment completion (RR 1.00, 95% CI 0.92 to 1.09; P = 0.99). There was also low quality evidence that LHWs may reduce child morbidity (RR 0.86, 95% CI 0.75 to 0.99; P = 0.03) and child (RR 0.75, 95% CI 0.55 to 1.03; P = 0.07) and neonatal (RR 0.76, 95% CI 0.57 to 1.02; P = 0.07) mortality, and increase the likelihood of seeking care for childhood illness (RR 1.33, 95% CI 0.86 to 2.05; P = 0.20). For other health issues, the evidence is insufficient to draw conclusions regarding effectiveness, or to enable the identification of specific LHW training or intervention strategies likely to be most effective. AUTHORS' CONCLUSIONS: LHWs provide promising benefits in promoting immunisation uptake and breastfeeding, improving TB treatment outcomes, and reducing child morbidity and mortality when compared to usual care. For other health issues, evidence is insufficient to draw conclusions about the effects of LHWs.

Perceived church-based needs and assets for HIV/AIDS prevention in an urban Nigerian community.

Health intervention programs have the potential to use church-based assets to address a wide range of health issues. This study examined the assets Nigerian church members believed their churches needed, including the assets they thought they had to engage in HIV/AIDS prevention activities. Eight hundred and thirty members from 83 churches completed a questionnaire designed from forum focus group data. Respondents were males and females aged 18 years old and above, with primary, secondary, university, or vocational education, and were more likely to be married than single (never married), separated, divorced, widowed or remarried. The data revealed that church members needed access to health promotion assets, including the expertise of members who are health professionals to engage in HIV/AIDS prevention activities. We recommend an intensive HIV/AIDS prevention reorientation-training workshop for church leaders to ensure a sustainable plan to address HIV/AIDS prevention needs.

Perceived importance of church-based assets to HIV/AIDS prevention and control in a Nigerian city.

This study explored the extent to which church members thought the assets they might have to engage in HIV/AIDS prevention and control activities were important. Eight hundred and thirty members from 83 Christian churches in Aba, Nigeria completed a multi-item survey questionnaire designed to obtain information on the importance they attached to church-based assets relevant to HIV/AIDS prevention and control. The rating of importance of assets was on a scale of 1 to 5. Rating on the importance of assets was highest in the spiritual asset category (mean = 4.20), followed by health education (4.02), capacity building (4.01), social (3.62), and financial assets (3.54). Among the denominational assets, free HIV/AIDS drug donation was rated higher (4.10) than other assets in the subcategories. This study demonstrates the usefulness of ascertaining members' perspectives on the importance of church-based assets and provides a basis for recommendation to health education administrators.