ASPPH logo


Member Research & Reports

Member Research & Reports

Arizona Researchers Investigate the Role of CHWs in Preventing and Managing Diabetes

Non-communicable diseases (NCDs) pose a high priority threat to public health worldwide. Among the NCDs of global significance, Type 2 Diabetes Mellitus (T2DM) is especially common. Despite numerous initiatives to prevent diabetes and diabetes-related complications, the disease remains the fourth leading cause of disease-related deaths globally, with almost 80 percent occurring in low- and middle-income countries (LMICs).

[Photo: Dr. Halimatou Alaofè]

Community Health Workers (CHW) are uniquely positioned to collaborate with clinicians, diabetes educators, and other health care providers in efforts to prevent and management Type 2 diabetes. CHWs in LMICs have been invaluable in managing maternal and child health services, and in helping to reduce the burden of such infectious diseases as malaria, tuberculosis, and sexually transmitted infections. However, we do not know the extent to which they can be effective in preventing and managing the burgeoning chronic, non-communicable diseases in LMICs.

To summarize and critically appraise evidence regarding the effectiveness of CHW interventions for preventing and managing T2DM in LMICs, investigators at the University of Arizona Mel and Enid Zuckerman College of Public Health and their colleagues in the Department of Community Health and Primary Care at the University of Lagos College of Medicine, Nigeria, conducted a systematic review of available data.

The full report is published in the current issue of Annals of Global Health.

To identify studies that reported the effect of CHW interventions for preventing and managing T2DM in LMICs, they conducted a comprehensive search of data published from inception to May 31, 2017. Ten studies met the inclusion criteria. As the data revealed, the role of CHWs included among others, patient education, identification and referral of high-risk individuals to clinicians, and provision of social support through home visits. Positive outcomes were reported in seven of the ten studies.

The outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased medication adherence; and improved fasting blood sugar, glycated hemoglobin, and body mass index. Three studies showed no significant outcomes.

The report concluded that CHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. However, given the limited number of effectiveness studies of rigorous quality that qualified for inclusion in the review, robust conclusions cannot be drawn at the present time.

Community Health Workers in Diabetes Prevention and Management in Developing Countries” was published in Annals of Global Health. Epub: 11/22/20