Community Health Workers in Diabetes Prevention and Management in Developing Countries

Halimatou Alaofè, Ibitola Asaolu, Jennifer Ehiri, Hayley Moretz, Chisom Asuzu, Mobolanle Balogun, Olayinka Abosede, John Ehiri

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations


Background There is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of type 2 diabetes mellitus (T2DM) in LMICs. Methods To identify studies that reported the effect of CHW interventions for prevention and management of T2DM in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane Metabolic and Endocrine Disorders Group's Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017. Findings Ten studies were included (4 pre- and post-studies, 2 randomized controlled trials, 2 cohort studies, 1 cross-sectional study, and 1 case-control study). The role of CHWs consisted of patient education, identification and referral of high-risk individuals to physicians, and provision of social support through home visits. Positive outcomes were reported in 7 of 10 studies. These outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased medication adherence; and improved fasting blood sugar, glycated hemoglobin, and body mass index. Three studies showed no significant outcomes. Conclusions CHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. Given the limited number of studies included in this review, robust conclusions cannot be drawn at the present time.

Original languageEnglish (US)
Pages (from-to)661-675
Number of pages15
JournalAnnals of Global Health
Issue number3-4
StatePublished - May 2017


  • community health worker
  • diabetes
  • diabetes management
  • diabetes prevention
  • low-and middle-income countries

ASJC Scopus subject areas

  • General Medicine


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