{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T01:54:41Z","timestamp":1783562081330,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/P000649\/1"],"award-info":[{"award-number":["ES\/P000649\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000374","name":"British Medical Association","doi-asserted-by":"publisher","award":["2018\/a"],"award-info":[{"award-number":["2018\/a"]}],"id":[{"id":"10.13039\/501100000374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Community Health Workers are one way to address the shortage of ear and hearing care specialists in low\u2010resource settings. However, there are few reports evaluating training and service delivery by Community Health Workers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, setting and participants<\/jats:title><jats:p>We trained 13 Community Health Workers in primary ear and hearing care in Mukono District, Uganda. Community Health Workers attended a two\u2010day training workshop and received remote supervision thereafter during service delivery in the community. An ear camp was held at the local health centre every two months, where a local ENT specialist could assess referred cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Clinical and diagnostic skills and decision\u2010making were assessed using an Objective Structured Clinical Examination, with scores recorded at baseline and six months. Service delivery was evaluated by analysing the following: (i) number of individuals evaluated; (ii) treatments delivered; (iii) cases referred for specialist opinion; (iv) proportion of appropriately referred cases; and (v) agreement between Community Health Worker and specialist diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Observed Structured Clinical Examination scores were high and stable for six months. 312 individuals were screened in the community by the Community Health Workers, with 298 classified as having an abnormality. Care was delivered in the community to 167 of these, and the remaining 131 referred to the ear camp. Diagnostic agreement was 39%, but 98% of referrals were deemed \u201cappropriate\u201d by the ENT specialist. 27 individuals self\u2010presented to the ear camp without prior assessment by a Community Health Worker, and 97% of these were deemed appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Trained Community Health Workers can play an important role in delivering ear and hearing services. Future work should look to explore this model in other contexts and\/or compare it to other models of service delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13815","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T07:45:16Z","timestamp":1621928716000},"page":"1193-1199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Training, supervision and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7248-5436","authenticated-orcid":false,"given":"James","family":"O\u2019Donovan","sequence":"first","affiliation":[{"name":"Learning and New Technologies Research Group Department of Education University of Oxford Oxford UK"},{"name":"Division of Research and Health Equity Omni Med Mukono Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Nakku","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Mbarara University of Science and Technology Mbarara Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Nyanzi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kabale University Kabale Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Nakasagga","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Mbarara University of Science and Technology Mbarara Uganda"},{"name":"Department of Ear, Nose and Throat Surgery Kampala International University Ishaka Bushenyi Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Hamala","sequence":"additional","affiliation":[{"name":"Division of Research and Health Equity Omni Med Mukono Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan S.","family":"Namanda","sequence":"additional","affiliation":[{"name":"Division of Research and Health Equity Omni Med Mukono Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Kabali","sequence":"additional","affiliation":[{"name":"Division of Research and Health Equity Omni Med Mukono Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"Winters","sequence":"additional","affiliation":[{"name":"Learning and New Technologies Research Group Department of Education University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly","family":"Chadha","sequence":"additional","affiliation":[{"name":"WHO Programme for Prevention of Deafness and Hearing Loss World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood F.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Department of ENT Brighton and Sussex University Hospitals NHS Trust Brighton UK"},{"name":"Brighton and Sussex Medical School Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"The World Health Organization.Action for Hearing Loss \u2013 Make a Sound Investment 2017. 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