Abstract
BackgroundThe health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services.MethodsWe reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading ‘sub-Saharan Africa’ to identify English language abstracts of original research articles on generalist and specialist CHWs.ResultsA total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services.ConclusionsThis review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted.
Highlights
The World Health Organization (WHO) defines adolescence as the period of time between 10 and 19 years of age, while the United Nations (UN) has historically relied on the term ‘youth’ to describe individuals between 15 and 24 years of age [1,2]
The findings indicate that the number of articles reporting specialized Community health worker (CHW) for malaria is higher in comparison to other conditions, which may be reflective of health systems in sub-Saharan Africa
If Youth Friendly Health Services (YFHS) is to be successful in improving the health and well-being of adolescents in sub-Saharan Africa, innovative approaches to service delivery and outreach, such as those related to CHWs, need to be explored
Summary
The World Health Organization (WHO) defines adolescence as the period of time between 10 and 19 years of age, while the United Nations (UN) has historically relied on the term ‘youth’ to describe individuals between 15 and 24 years of age [1,2] Both terms refer to an age group that is affected by the structural and proximal social determinants of health and development. The health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services
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