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Barriers and Facilitators of Engaging Community Health Workers in Non-Communicable Disease (NCD) Prevention and Control in China: A Systematic Review (2006–2016)

Author

Listed:
  • Hongfei Long

    (Global Health Program, Duke Kunshan University, Kunshan 215347, Jiangsu, China)

  • Wenting Huang

    (Global Health Program, Duke Kunshan University, Kunshan 215347, Jiangsu, China)

  • Pinpin Zheng

    (Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai 200032, China)

  • Jiang Li

    (Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai 200032, China)

  • Sha Tao

    (Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai 200032, China)

  • Shenglan Tang

    (Global Health Program, Duke Kunshan University, Kunshan 215347, Jiangsu, China
    Duke Global Health Institute, Duke University, Durham, NC 27710, USA)

  • Abu S. Abdullah

    (Global Health Program, Duke Kunshan University, Kunshan 215347, Jiangsu, China
    Duke Global Health Institute, Duke University, Durham, NC 27710, USA
    Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA)

Abstract

Background : Non-communicable diseases (NCDs) have become a dominant disease burden in China. Although China has a prevention-centered NCD strategy, the implementation effect in the community has been subjected to manpower and financial difficulties. Engaging community health workers (CHWs) in community-based interventions may be a cost-effective approach to relieve the resource shortage and improve health. This review aimed to synthesize evidence on types of NCD-related care that was provided by CHWs in China, and to identify relevant barriers and facilitators. Methods : A literature search was conducted in Medline, PubMed, ProQuest, and Google Scholar databases for English-written, peer-reviewed articles published from 1996 to 2016 that reported findings from NCD-related interventions delivered by CHWs in China. Each article was extracted independently by two researchers. Results : Twenty distinct studies met the inclusion criteria. The two most common types of CHW-led NCD-related care were diabetes and hypertension management ( n = 7) and mental health care ( n = 7). Thirteen studies discussed the barriers and 16 studies reported facilitators. The most common barriers included lack of support ( n = 6), lack of resources ( n = 4), and heavy reliance on technology ( n = 4). The common facilitators included an integrated health system ( n = 9), community and patient trust ( n = 5), high quality training ( n = 5), and CHWs’ capacity ( n = 5). Fourteen studies mentioned training content, while only eight described detailed procedures and duration. Conclusions : This review suggests that trained and supervised Chinese CHWs had the capacity to provide grassroots NCDs preventive interventions. In order to increase the generalizability and sustainability of such programs, studies with robust designs are needed to explore the effectiveness of CHW-led programs, and the intervention strategies to improve the practice of CHWs in various settings.

Suggested Citation

  • Hongfei Long & Wenting Huang & Pinpin Zheng & Jiang Li & Sha Tao & Shenglan Tang & Abu S. Abdullah, 2018. "Barriers and Facilitators of Engaging Community Health Workers in Non-Communicable Disease (NCD) Prevention and Control in China: A Systematic Review (2006–2016)," IJERPH, MDPI, vol. 15(11), pages 1-22, October.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:11:p:2378-:d:178627
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    References listed on IDEAS

    as
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    4. Reininger, Belinda M. & Mitchell-Bennett, Lisa & Lee, MinJae & Gowen, Rose Z. & Barroso, Cristina S. & Gay, Jennifer L. & Saldana, Mayra Vanessa, 2015. "Tu Salud, ¡Si Cuenta!: Exposure to a community-wide campaign and its associations with physical activity and fruit and vegetable consumption among individuals of Mexican descent," Social Science & Medicine, Elsevier, vol. 143(C), pages 98-106.
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