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Nutrition and Health in a Developing World pp 625–645Cite as

Integrated Approaches to Health and Nutrition: Role of Communities

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Part of the book series: Nutrition and Health ((NH))

Abstract

Despite considerable global progress against health-related Millennium Development Goals, gains made in different regions of the world have been uneven. 6.3 million deaths among children under age five, 289 thousand maternal deaths still occur each year, and 99% of these deaths occur in low- and middle-income countries (LMICs). Inadequate health systems and crippling human resource shortages pose serious bottlenecks to the achievement of health goals. Health system gaps disproportionately impact poor, marginalized populations, in both rural and urban contexts. Compounding major health system gaps, demand-side barriers have been shown to prevent or discourage individuals from seeking care even when adequate health services exist. Religious, cultural and social norms may preclude health-promoting behaviours. Poor and vulnerable populations are less likely to enjoy access to health-related information, challenging their ability to make informed decisions about when, where and how to seek care. Costs, including treatment, transportation and opportunity cost, also represent significant obstacles to seeking care. Both supply and demand-side gaps are impeding progress in achieving good health in societies. For decades, lay health workers and communities have stepped into fill these gaps. The global Sustainable Development Goals (SDGs) adopted in 2015 has shifted the focus from disease-specific interventions and poverty in LMICs to addressing issues of sustainability, human rights, social inclusion and justice and ensuring “no one is left behind”. Governments worldwide have rightly adopted sector-specific approaches to addressing problems with proven solutions. While interventions were aimed at communities in the past, governments are now increasing public welfare and domestic transfers to individuals. How these transfers, local programmes and public welfare platforms can be best leveraged to achieve good health and overall development pose interesting questions and debates on existing and future models of governance. Physical and virtual communities will need to be leveraged in the most optimal way.

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Notes

  1. 1.

    The 2015 WHO guidelines recommend that ART should be initiated in everyone living with HIV at any CD4 cell count.

  2. 2.

    Including goals concerning hunger (Goal 1, Target 1.C); under-five mortality (Goal 4, Target 4.A); maternal mortality (Goal 5, Target 5.A); access to reproductive health (Goal 5, Target 5.B); spread of HIV/AIDS (Goal 6, Target 6.A); access to treatment for HIV/AIDS (Goal 6, Target 6.A); incidence of malaria and other major diseases (Goal 6, Target 6.C); access to safe drinking water and basic sanitation (Goal 7, Target 7.C); and access to affordable essential drugs (Goal 8, Target 8.E).

References

  1. Morgan LM. Community participation in health: perpetual allure, persistent challenge. Health Policy Plann. 2001;16(3):221–30.

    Article  CAS  Google Scholar 

  2. Rosato M, Laverack G, Grabman LH, Tripathy P, Nair N, Mwansambo C, et al. Community participation: lessons for maternal, newborn, and child health. Lancet. 2008;372(9642):962–71.

    Article  PubMed  Google Scholar 

  3. Schneider H, Hlophe H, van Rensburg D. Community health workers and the response to HIV/AIDS in South Africa: tensions and prospects. Health Policy Plann. 2008;23(3):179–87.

    Article  Google Scholar 

  4. MacQueen KM, McLellan E, Metzger DS, Kegeles S, Strauss RP, Scotti R, et al. What is community? An evidence-based definition for participatory public health. Am J Public Health. 2001;91(12):1929–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Chorbev I, Sotirovska M, Mihajlov D. Virtual communities for diabetes chronic disease healthcare. Int J Telemed Appl. 2011;2011:721654.

    PubMed  PubMed Central  Google Scholar 

  6. Demiris G. The diffusion of virtual communities in health care: concepts and challenges. Patient Educ Couns. 2006;62(2):178–88.

    Article  PubMed  Google Scholar 

  7. Packer CAA. Using human rights to change tradition. International Specialized Book Service Inc; 2002.

    Google Scholar 

  8. WHO. Health and human rights factsheet. 2015.

    Google Scholar 

  9. Ensor T, Cooper S. Overcoming barriers to health service access: influencing the demand side. Health Policy Plann. 2004;19(2):69–79.

    Article  Google Scholar 

  10. Nualart GB. The Mahila Samakhya program: empowering education for women’s equality in Indian disadvantaged communities and rural areas. Commun Pap—Media Literacy Gend Stud. 2012;1:115–32.

    Google Scholar 

  11. Ganle JK, Parker M, Fitzpatrick R, Otupiri E. A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition. BMC Pregnancy Childbirth. 2014;14:425.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Davtyan M, Brown B, Folayan MO. Addressing Ebola-related stigma: lessons learned from HIV/AIDS. Glob Health Action. 2014;7:26058.

    Article  PubMed  Google Scholar 

  13. Gonsalves G, Staley P. Panic, paranoia, and public health—the AIDS epidemic’s lessons for Ebola. N Engl J Med. 2014;371(25):2348–9.

    Article  CAS  PubMed  Google Scholar 

  14. Manandhar DS, Osrin D, Shrestha BP, Mesko N, Morrison J, Tumbahangphe KM, et al. Effect of a participatory intervention with women’s groups on birth outcomes in Nepal: cluster-randomised controlled trial. Lancet. 2004;364(9438):970–9.

    Article  PubMed  Google Scholar 

  15. Taleb F, Perkins J, Ali NA, Capello C, Ali M, Santarelli C, et al. Transforming maternal and newborn health social norms and practices to increase utilization of health services in rural Bangladesh: a qualitative review. BMC Pregnancy Childbirth. 2015;15:75.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lehmann U, Sanders D. Community health workers: what do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. WHO, School of Public Health University of the Western Cape. 2007.

    Google Scholar 

  17. WHO. Working with individuals, families and communities to improve maternal and newborn health. 2010.

    Google Scholar 

  18. Gilmore B, McAuliffe E. Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review. BMC Public Health. 2013;13:847.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Perry HB, Zulliger R, Rogers MM. Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annu Rev Public Health. 2014;35:399–421.

    Article  PubMed  Google Scholar 

  20. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.

    Article  PubMed  Google Scholar 

  21. Imdad A, Yakoob MY, Sudfeld C, Haider BA, Black RE, Bhutta ZA. Impact of vitamin A supplementation on infant and childhood mortality. BMC Public Health. 2011;11(Suppl 3):S20.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Monasch R, Reinisch A, Steketee RW, Korenromp EL, Alnwick D, Bergevin Y. Child coverage with mosquito nets and malaria treatment from population-based surveys in African countries: a baseline for monitoring progress in roll back malaria. Am J Trop Med Hyg. 2004;71(2 Suppl):232–8.

    PubMed  Google Scholar 

  23. Hopkins H, Talisuna A, Whitty CJ, Staedke SG. Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence. Malaria J. 2007;6:134.

    Article  Google Scholar 

  24. Leon N, Sanders D, Van Damme W, Besada D, Daviaud E, Oliphant NP, et al. The role of ‘hidden’ community volunteers in community-based health service delivery platforms: examples from sub-Saharan Africa. Glob Health Action. 2015;8:27214.

    Article  Google Scholar 

  25. Lassi ZS, Das JK, Salam RA, Bhutta ZA. Evidence from community level inputs to improve quality of care for maternal and newborn health: interventions and findings. Reprod Health. 2014;11(Suppl 2):S2.

    Article  Google Scholar 

  26. Perez LM, Martinez J. Community health workers: social justice and policy advocates for community health and well-being. Am J Public Health. 2008;98(1):11–4.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Rosenthal EL, Wiggins N, Ingram M, Mayfield-Johnson S, De Zapien JG. Community health workers then and now: an overview of national studies aimed at defining the field. J Ambul Care Manag. 2011;34(3):247–59.

    Article  Google Scholar 

  28. Ingram M, Sabo S, Rothers J, Wennerstrom A, de Zapien JG. Community health workers and community advocacy: addressing health disparities. J Commun Health. 2008;33(6):417–24.

    Article  Google Scholar 

  29. Farquhar SA, Michael YL, Wiggins N. Building on leadership and social capital to create change in 2 urban communities. Am J Public Health. 2005;95(4):596–601.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Frew E, Wolstenholme JL, Atkin W, Whynes DK. Estimating time and travel costs incurred in clinic based screening: flexible sigmoidoscopy screening for colorectal cancer. J Med Screen. 1999;6(3):119–23.

    Article  CAS  PubMed  Google Scholar 

  31. Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:161–71.

    Article  PubMed  Google Scholar 

  32. Stein MD, Crystal S, Cunningham WE, Ananthanarayanan A, Andersen RM, Turner BJ, et al. Delays in seeking HIV care due to competing caregiver responsibilities. Am J Public Health. 2000;90(7):1138–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. van Lonkhuijzen L, Stegemen M, Nyirongo R, van Roosmalen J. Use of maternity waiting home in rural Zambia. Afr J Reprod Health. 2003;7(1):32–6.

    Google Scholar 

  34. Decroo T, Rasschaert F, Telfer B, Remartinez D, Laga M, Ford N. Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review. Int Health. 2013;5(3):169–79.

    Article  PubMed  Google Scholar 

  35. Bolam A, Manandhar DS, Shrestha P, Ellis M, Costello AM. The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial. BMJ. 1998;316(7134):805–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Stanback J, Mbonye AK, Bekiita M. Contraceptive injections by community health workers in Uganda: a nonrandomized community trial. Bull World Health Organ. 2007;85(10):768–73.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kwan CK, Ernst JD. HIV and tuberculosis: a deadly human syndemic. Clin Microbiol Rev. 2011;24(2):351–76.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mehra D, de Pee S, Bloem MW. Nutrition, food security, social protection, and health systems strengthening for ending AIDS. In: Ivers L, editor. Food insecurity and public health. CRC Press; 2015.

    Google Scholar 

  39. WHO. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. 2015.

    Google Scholar 

  40. WHO. World health statistics 2015.

    Google Scholar 

  41. WHO. Treat, train, retain the AIDS and health workforce plan: WHO report on the consultation on AIDS and human resources for health, Geneva. 2006.

    Google Scholar 

  42. Gray N, Bedford J, Deconinck H, Brown, R (CMAM Forum and Anthrologica). Community engagement: the ‘C’ at the heart of CMAM. 2014.

    Google Scholar 

  43. Neupane D, Kallestrup P, McLachlan CS, Perry H. Community health workers for non-communicable diseases. Lancet Glob Health. 2014;2(10):e567.

    Article  PubMed  Google Scholar 

  44. Kruk ME, Paczkowski M, Mbaruku G, de Pinho H, Galea S. Women’s preferences for place of delivery in rural Tanzania: a population-based discrete choice experiment. Am J Public Health. 2009;99(9):1666–72.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Paz-Soldan VA, Alban RE, Jones CD, Oberhelman RA. The provision of and need for social support among adult and pediatric patients with tuberculosis in Lima, Peru: a qualitative study. BMC Health Serv Res. 2013;13:290.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Cobb S. Presidential address-1976. Social support as a moderator of life stress. Psychosom Med. 1976;38(5):300–14.

    Article  CAS  PubMed  Google Scholar 

  47. Standing H, Chowdhury AM. Producing effective knowledge agents in a pluralistic environment: what future for community health workers? Soc Sci Med. 2008;66(10):2096–107.

    Article  CAS  PubMed  Google Scholar 

  48. Christopher JB, Le May A, Lewin S, Ross DA. Thirty years after Alma-Ata: a systematic review of the impact of community health workers delivering curative interventions against malaria, pneumonia and diarrhoea on child mortality and morbidity in sub-Saharan Africa. Hum Res Health. 2011;9:27.

    Article  Google Scholar 

  49. Gilson LWG, Heggenhougen K, Owuor-Omondi L, Perera M, Ross D, Salazar L. National community health worker programs: how can they be strengthened? J Public Health Policy. 1989;10(4):518–32.

    Article  CAS  PubMed  Google Scholar 

  50. Walley J, Lawn JE, Tinker A, de Francisco A, Chopra M, Rudan I, et al. Primary health care: making Alma-Ata a reality. Lancet. 2008;372(9642):1001–7.

    Article  PubMed  Google Scholar 

  51. Mason JB, Sanders D, Musgrove P, Soekirman, Galloway R. Community health and nutrition programs. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al., editors. Disease control priorities in developing countries. 2nd ed. Washington (DC); 2006.

    Google Scholar 

  52. Nations U. Global trends and challenges to sustainable development post-2015. In: Nations U, editor. World Economic and Social Survey 2013: The Department of Economic and Social Affairs of the United Nations Secretariat; 2013.

    Google Scholar 

  53. WHO. The global burden of disease: 2004 update. 2004.

    Google Scholar 

  54. Children St. The urban disadvantage: state of the world’s mothers 2015. Save the children. 2015.

    Google Scholar 

  55. Kuenne CW, Adamczyk S, Rass M, Bullinger AC, Moeslein KM. IT-based interaction platforms to foster virtual patient communities. Institut für Wirtschaftsinformatik Friedrich-Alexander Universität Erlangen-Nürnberg, 2011.

    Google Scholar 

  56. Finn J. An exploration of helping processes in an online self-help group focusing on issues of disability. Health Soc Work. 1999;24(3):220–31.

    Article  CAS  PubMed  Google Scholar 

  57. Eysenbach G, Powell J, Englesakis M, Rizo C, Stern A. Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ. 2004;328(7449):1166.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Vega S, Marciscano I, Holcomb M, Erps KA, Major J, Lopez AM, et al. Testing a top-down strategy for establishing a sustainable telemedicine program in a developing country: the Arizona telemedicine program-US Army-Republic of Panama Initiative. Telemed J E Health. 2013;19(10):746–53.

    Article  PubMed  Google Scholar 

  59. Griffiths F, Dobermann T, Cave JA, Thorogood M, Johnson S, Salamatian K, et al. The impact of online social networks on health and health systems: a scoping review and case studies. Policy Internet. 2015;7(4):473–96.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Bonnesen L. Cash transfers—a viable approach to development? 2012.

    Google Scholar 

  61. Norton A, Conway T, Foster M. Social protection concepts and approaches: implications for policy and practice in international development. Overseas Development Institute; 2011.

    Google Scholar 

  62. Hossain M. Credit for alleviation of rural poverty: The Grameen Bank in Bangladesh. 1988.

    Google Scholar 

  63. Rahman MH, Da Vanzo J. Assessing the impact of the Grameen Bank on women’s status and fertility in Bangladesh. RAND research. 1993.

    Google Scholar 

  64. Fox T. ‘Prêt-à-Payer’ app to directly fund secondary schoolchildren in West Africa 2014. Available from: http://ucsdnews.ucsd.edu/pressrelease/pret_a_payer_app_to_directly_fund_secondary_schoolchildren_in_west_africa.

  65. Lee H, Whitley E. Time and information technology: temporal impacts on individuals, organizations, and society. Inf Soc. 2002;18:235–40.

    Article  Google Scholar 

  66. Aker JC. Dial, “A” for agriculture: a review of information and communication technologies for agricultural extension in developing countries. Agric Econ. 2011;42:631–47.

    Article  Google Scholar 

  67. Fanzo J, Marshall Q, Wong J, Merchan RI, Jaber MI, Souza A, Verjee N. The integration of nutrition into extension and advisory services: a synthesis of experiences, lessons, and recommendations. Lindau, Switzerland: Global Forum for Rural Advisory Services; 2013.

    Google Scholar 

  68. Lucwaba K, Everts S. Siyadingana: we need each other. J Ambul Care Manag. 2015;38(3):217–8.

    Article  Google Scholar 

  69. Gomez EJ. Decentralization and sub-national governance: new methodological tools and evidence for cross-regional analysis world bank thematic seminar series on decentralization and sub-national governance. Washington D.C.; 2001.

    Google Scholar 

  70. Gomez EJ. A temporal analytical approach to decentralization: lessons from Brazil’s health sector. J Health Polit Policy Law. 2008;33(1):53–91.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Nutrition Division, World Food Programme, Rome, Italy

    Olivia Lange, Divya Mehra, Saskia de Pee & Martin W. Bloem

  2. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA

    Saskia de Pee & Martin W. Bloem

  3. Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Martin W. Bloem

Authors
  1. Olivia Lange
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  2. Divya Mehra
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  3. Saskia de Pee
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  4. Martin W. Bloem
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Corresponding authors

Correspondence to Divya Mehra or Martin W. Bloem .

Editor information

Editors and Affiliations

  1. World Food Programme , Rome, Italy

    Saskia de Pee

  2. School of Public Health, University of Arizona Mel and Enid Zuckerman, Tucson, Arizona, USA

    Douglas Taren

  3. World Food Programme, Nutrition Division , Rome, Italy

    Martin W. Bloem

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Lange, O., Mehra, D., de Pee, S., Bloem, M.W. (2017). Integrated Approaches to Health and Nutrition: Role of Communities. In: de Pee, S., Taren, D., Bloem, M. (eds) Nutrition and Health in a Developing World . Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-43739-2_28

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  • DOI: https://doi.org/10.1007/978-3-319-43739-2_28

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