Tuberculosis Clinical Trial
Official title:
Training Lay Healthcare Workers to Optimize TB Care and Improve Outcomes in Malawi
Task shifting of less complex healthcare tasks to lay health workers (LHWs) is increasingly
employed strategy to address the global shortage of skilled health workers. Despite
availability of effective treatment, tuberculosis (TB) remains an important cause of
mortality with 1.3 million lives lost globally to TB in 2012. The greatest proportion of new
TB cases occurs in Africa and over 95% of TB deaths occur in low income countries (LICs). In
response to the combined high TB burden and severe healthcare worker shortages in these
settings, outpatient TB care is among the tasks commonly shifted to LHWs.
LHWs are community members who have received some training but are not healthcare
professionals. Randomised trials show LHWs improve access to basic health services and TB
treatment outcomes, however, insufficient training and supervision are recognized barriers to
their effectiveness.
The investigators' goal is to improve TB care provided by LHWs in Malawi by implementing and
evaluating a knowledge translation (KT) strategy designed to facilitate incorporation of
evidence into LHW practice. The investigators will employ a mixed methods design including a
pragmatic cluster randomized controlled trial to evaluate effectiveness of the strategy and
qualitative methods to understand barriers and facilitators to scalability and sustainability
of the program.
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