2023-09-28 14:46:10 +00:00
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abstract: 'Addressing urban health challenges in low- and middle-income countries
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(LMICs) has been hampered by lack of evidence on effective mechanisms
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for delivering health services to the poor. The urban disadvantaged
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experience poor health outcomes (often worse than rural counterparts)
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and face service barriers. While community health workers (CHWs) have
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been extensively employed in rural communities to address inequities,
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little attention has been given to understanding the roles of CHWs in
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urban contexts. This study is the first to systematically examine urban
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CHW roles in LMICs. It aims to understand their roles vis-a-vis other
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health providers and raise considerations for informing future scope of
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practice and service delivery models. We developed a framework that
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presents seven key roles performed by urban CHWs and position these
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roles against a continuum of technical to political functions. Our
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scoping review included publications from four databases (MEDLINE,
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EMBASE, CINAHL and Social Sciences Citation Index) and two CHW resource
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hubs. We included all peer-reviewed, CHW studies situated in
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urban/peri-urban, LMIC contexts. We identify roles (un)commonly
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performed by urban CHWs, present the range of evidence available on CHW
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effectiveness in performing each role and identify considerations for
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informing future roles. Of 856 articles, 160 met the inclusion criteria.
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Programmes spanned 34 LMICs. Studies most commonly reported evidence on
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CHWs roles related to health education, outreach and elements of direct
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service provision. We found little overlap in roles between CHWs and
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other providers, with some exceptions. Reported roles were biased
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towards home visiting and individual-capacity building, and not
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well-oriented to reach men/youth/working women, support community
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empowerment or link with social services. Urban-specific adaptations to
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roles, such as peer outreach to high-risk, stigmatized communities, were
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limited. Innovation in urban CHW roles and a better understanding of the
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unique opportunities presented by urban settings is needed to fully
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capitalize on their potential.'
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affiliation: 'Ludwick, T (Corresponding Author), Univ Melbourne, Melbourne Sch Populat
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\& Global Hlth, Nossal Inst Global Hlth, 333 Exhibit St, Melbourne, Vic 3004, Australia.
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Ludwick, Teralynn; McPake, Barbara, Univ Melbourne, Melbourne Sch Populat \& Global
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Hlth, Nossal Inst Global Hlth, 333 Exhibit St, Melbourne, Vic 3004, Australia.
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Morgan, Alison; Kane, Sumit, Univ Melbourne, Melbourne Sch Populat \& Global Hlth,
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Nossal Inst Global Hlth, Maternal Sexual \& Reprod Hlth Unit, Melbourne, Vic, Australia.
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Kelaher, Margaret, Univ Melbourne, Ctr Hlth Policy, Melbourne Sch Populat \& Global
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Hlth, Melbourne, Vic, Australia.'
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author: Ludwick, Teralynn and Morgan, Alison and Kane, Sumit and Kelaher, Margaret
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and McPake, Barbara
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author-email: teralynn.ludwick@unimelb.edu.au
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author_list:
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- family: Ludwick
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given: Teralynn
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- family: Morgan
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given: Alison
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- family: Kane
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given: Sumit
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- family: Kelaher
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given: Margaret
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- family: McPake
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given: Barbara
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da: '2023-09-28'
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doi: 10.1093/heapol/czaa049
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eissn: 1460-2237
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files: []
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issn: 0268-1080
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journal: HEALTH POLICY AND PLANNING
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keywords: 'Urban health; community health; human resources; low- and middle-income
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countries; health inequalities; review'
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keywords-plus: 'SOUTH-AFRICA; COST-EFFECTIVENESS; SMOKING-CESSATION; RANDOMIZED-TRIAL;
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PEER EDUCATION; CHILD HEALTH; NEWBORN CARE; HOME VISITS; CAPE-TOWN;
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INTERVENTION'
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language: English
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month: OCT
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number: '8'
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number-of-cited-references: '131'
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orcid-numbers: 'McPake, Barbara/0000-0002-9904-1077
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Ludwick, Teralynn/0000-0003-4160-7354
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Kane, Sumit/0000-0002-4858-7344
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Morgan, Alison/0000-0001-5380-1619'
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pages: 1039-1052
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papis_id: e471994528e3475c435997c026f2f354
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ref: Ludwick2020distinctiveroles
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researcherid-numbers: 'McPake, Barbara/AAE-8655-2021
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Ludwick, Teralynn/AAZ-3458-2020
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'
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tags:
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- review
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times-cited: '11'
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title: 'The distinctive roles of urban community health workers in low- and middle-income
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countries: a scoping review of the literature'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000593028300016
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usage-count-last-180-days: '1'
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usage-count-since-2013: '9'
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volume: '35'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2020'
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