1433Community Health Workers for non-communicable diseases: a systematic review and meta-analysis

Abstract Background We evaluated the effectiveness of various community health workers (CHWs)-led interventions for several non-communicable diseases (NCD) risk-factors in both low- to middle-income countries (LMICs) and high-income countries (HICs). Methods We included interventions by CHWs targeting the uptake of services for NCDs and conducted meta-analyses of randomized controlled trials. Net differences in blood pressure (BP), glycated hemoglobin (HbA1c), fasting blood glucose, triglycerides, low-density lipoprotein-cholesterol (LDL-C) cholesterol, and body mass index (BMI) were calculated between intervention and control groups . Results Seventy-three studies were included. CHWs-led interventions were effective in reducing systolic BP -2.94 mmHg [95% CI: -4.28 to -1.59; I2=73%], diastolic BP -1.59 mmHg [-2.54 to -0.64; 81% ], HbA1c% -0.31 [-0.45 to -0.17; 52%], and triglycerides -8.32 mg/dl [-13.54 to -3.10; 0.0%]. The mean change in HbA1c% was detectable in studies undertaken in HICs [-0.35 (-0.45 to -0.1)] but not in LMICs [-0.03 (-0.21 to 0.15)]. Interventions targeting diabetes were also effective in reducing systolic BP by -2.30 mmHg (-4.22 to -0.38). There was no evidence that these interventions reduced BMI or LDL-C. Conclusions Engagement of CHWs is an effective strategy to reduce BP. They are also effective in reducing HbA1c and triglycerides in HICs; but further research is needed in LMICs. It also appears that interventions led by CHWs may be effective in reducing more than one risk factor simultaneously. Key messages Engaging CHWs is an important strategy to combat the growing burden of hypertension.