Abstract
BackgroundBrazil is seeing rapid population ageing, which is leading to new demands on primary health care services. There is a need to develop and assess the effectiveness of new interventions to build the capacity of staff, including community health workers, to meet the needs of groups such as care-dependent older people and their care-givers. This study examines the feasibility of a small training intervention piloted in the Brazilian city of Fortaleza.MethodsThe study evaluated participants’ own assessments of key knowledge and skills related to the needs of care-dependent older people, both before and after the training intervention. It also assessed their capacity to implement a simple screening tool of geriatric risk factors.ResultsThe participant self-assessments indicate significant improvements in their perceived knowledge and capacity in responding to the health needs of care-dependent older people. Additionally, participants were able to successfully conduct the home visits and screening for risk factors.ConclusionsThe study demonstrates the feasibility of developing interventions to enhance the capacity of community health workers to meet the needs of dependent older people in countries like Brazil. The evidence of effectiveness, though limited and subjective, provides justification for a larger, formally evaluated intervention. The experience of Fortaleza provides valuable lessons for other cities and countries in the region which are facing similar challenges.
Highlights
Brazil is seeing rapid population ageing, which is leading to new demands on primary health care services
A key fidelity indicator for the implementation of the training programme was the retention of Community health worker (CHW) through the class-based sessions and their effective participation in the practical home visits
The four who did not complete this element of the training programme expressed interest in participating, but it was not possible to fit the visits within their professional schedules
Summary
Brazil is seeing rapid population ageing, which is leading to new demands on primary health care services. There is a need to develop and assess the effectiveness of new interventions to build the capacity of staff, including community health workers, to meet the needs of groups such as care-dependent older people and their care-givers. This paper reviews a pilot training programme for community health workers (CHWs) in the Brazilian city of Fortaleza. % of total population 6.1 NA in the North East of Brazil, a region which, as a whole, has a lower level of economic and human development than the national average. Despite, this it has a similar population age composition to the national average, registering large increases in the number of people aged 70 or over
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