Table 1
Brief study characteristics
| Study | Setting (study design) | CHW and patient sample | Intervention type and description of trial arms | Outcomes (follow-up) |
| Andreoni 201646 Objective: test the effect of tailored contracts for CHWs conducting door-to-door immunisation drives in rural and urban Pakistan | Rural and urban Pakistan (2×2 factorial RCT) | Female CHWs (Ia+c=85, Ia+d=84, Cb+c=88, Cb+d=80). Patients: children under 5 years. (n=unspecified) |
Incentives I: a+c; a+d C: b+c; b+d (a) Employment contracts tailored to individual discounting preferences (b) Untailored contracts (c) Advanced allocation of daily work targets (d) Day-of allocation |
CHWs: Closeness to vaccine distribution policy objective Patients: None (Immediate) |
| Ashraf 201552 Objective: test the effect of advertising career possibilities at the recruitment stage for CHWs providing basic primary care | Rural Zambia (C-RCT) | CHWs (I=149, C=149). Patients: children under 5 years and women (n=unspecified) |
Recruitment I: Recruitment materials emphasising career possibilities C: Recruitment materials emphasising benefits to community |
CHWs: Home visits, patients seen, community meetings organised Patients: Use of services (18 months) |
| Ayele 199351 Objective: test the effect of an in-person refresher course and monthly ‘supportive’ supervision on CHW-led health promotion | Rural Ethiopia (C-RCT) | Male CHWs (I=50, C=50). Patient characteristics not reported (n=unspecified) |
Training-Supervision I: 5-day in-person refresher course and monthly supervision C: No refresher, no supervision |
CHWs: Composite functional status score Patients: None (6 months) |
| Bailey 199645 Objective: test the effect of tiered, interactive training featuring visual cue cards in improving CHW case management of diarrhoea | Rural Guatemala (RCT) | CHWs (I=22, C=27). Patient characteristics not reported (n=unspecified) |
Training I: Interactive, tiered training with visual cue cards C: Didactic training |
CHWs: knowledge score Patients: none (immediate) |
| Bossuroy 201653 Objective: test the effect of performance-based incentives on CHWs providing TB case detection and adherence counselling | Urban India (four-arm C-RCT) | CHWs (n=78). Adult patients (n=2500). |
Incentives Ia: Financial incentives based on patient detection for 6 months then based on treatment adherence Ib: Financial incentives based on patient detection for 6 months then a fixed salary Ic: Fixed salary for 6 months then incentives based on treatment adherence C: Fixed salary |
CHWs: TB case detection Patients: TB default rate (6 months) |
| Carrón 199450 Objective: test the effect of an interactive counselling guide and supervisory behavioural feedback instrument on CHWs distributing family planning materials | Rural Paraguay (2×2 factorial C-RCT) | Female CHWs (Ia=45, Ib=45, Ia+b=45, C=45). Patient characteristics not reported (n=unspecified) |
Training-Supervision I: a; b; a+b (a) Trained using interactive service algorithm (Decision tree) (b) Role-play based supervision (Behavioural feedback instrument) C: Usual training and supervision |
CHWs: quality of care provided Patients: none (12 months) |
| Chang 201148 Objective: test the effect of a mobile phone CHW support intervention on HIV care | Rural Uganda (C-RCT) | CHWs (I=13, C=16). Adult HIV+patients (I=446, C=524) |
Integration-Equipment I: A text message reporting system and health centre hotline C: No mobile health intervention (usual care) |
CHWs: none Patients: virological failure, adherence (2 years) |
| DeRenzi 2012A43 Objective: test the effect of SMS reminders on the promptness of routine CHW visits | Urban Tanzania (Pilot RCT) | Female CHWs (I=8, C=7). Patient characteristics not reported (n=unspecified) |
Supervision I: Escalating SMS reminder system C: No reminders |
CHWs: none Patients: change in closed referrals (24 days) |
| DeRenzi 2012B43 Objective: evaluate the impact of SMS reminders plus escalation to supervisor on the promptness of routine CHW visits | Urban Tanzania (RCT) | CHWs (I=34, C=40) Chronic care patients (n=unspecified) |
Supervision I: Escalating SMS reminder system and supervisor follow-up for underperforming CHWs C: No reminders |
CHWs: none Patients: mean time overdue at clinic (40 days) |
| DeRenzi 2012C43 Objective: test the effect of escalating to the supervisor versus SMS messages alone on the promptness of routine CHW visits | Urban Tanzania (RCT) | CHWs (n=87) Chronic care patients (n=unspecified) |
Supervision I: Escalating SMS reminder system and supervisor follow-up for underperforming CHWs C: Escalating SMS reminder system only |
CHWs: none Patients: mean time overdue at clinic (3 months) |
| Gautham 201542 Objective: test the effect of mobile phone-based, media-rich procedural guidance applications on CHWs providing primary care | Rural India (RCT) | CHWs (I=8, C=8). Paediatric and adult patients (I=65, C=61) |
Equipment I: Mobile phone–based, media-rich procedural guidance applications C: Paper guidelines |
CHWs: protocol compliance Patients: none (2 months) |
| Ginsburg 201444 Objective: test the effect of mobile guidance applications on CHWs referring women with abnormal breast exams | Rural Bangladesh (three-arm RCT) | Female CHWs (Ia=10, Ib=10, C=10). Female adult patients (Ia=246, Ib=240, C=70) |
Equipment (Ia)/ Training-Equipment (Ib) I: a; b (a) Smart phone with applications to guide interview, report data, show motivational video and offer an appointment (b) As in (a) plus additional ‘patient navigation training’ C: Paper-based tools |
CHWs: none Patients: adherence with referral (1 month) |
| Omer 200847 Objective: test the effect of an indigenous, evidence-based communication tool on CHWs providing maternal care | Urban Pakistan (C-RCT) | Female CHWs (I=52, C=unspecified). Mothers and their children (I=529, C=541) |
Integration-Training I: Indigenous, evidence-based communication tool C: Usual care |
CHWs: Home visits Patients: Uptake of protective health practices (10 months) |
| Winch 200349 Objective: test the effect of visual aids, refresher training, a counter referral recordkeeping notebook and a community meeting on CHWs treating common illnesses | Rural and Urban Mali (C-RCT) | CHWs (n=~102). Children<14 years. (n=152, C=134) |
Integration-Training-Reporting I: Visual aids, refresher training, a counter referral record-keeping notebook, a community meeting C: Standard training |
CHWs: proportion of children treated at home Patients: closed referrals |
, mean; C, control; CHW, community health worker; C-RCT, cluster RCT; I, intervention; N, intervention/control participant breakdown unspecified, total number of participants; RCT: randomised controlled trial; SMS, short messaging service (ie, text message); TB, tuberculosis; yrs, years.
