Community health worker-led interventions for cardio-metabolic diseases in India: Evidence from a systematic review and meta-analysis.

Authors

Suprakash Mandal, Priyanka Virdi, Kriti Singh, Rambha Pathak

Published in

The Indian journal of medical research. Volume 164. Issue 2. Pages 241-251.

Abstract

Background and objectives Cardio-metabolic diseases are leading cause of disability-adjusted life years (DALYs) in India. Community health workers' (CHW) local proximity and contextual understanding enable low-cost, and sustainable health interventions. This systematic review and meta-analysis of interventional studies aimed to identify types of CHW-led interventions and their effect on cardio-metabolic diseases. Methods Studies done in India (2000-2024) were searched from PubMed, Embase and Scopus databases. Screening of studies, followed by risk of bias assessment, data extraction was done and pooled mean difference (MD), 95% confidence interval (CI) was estimated by the random effect model. Subgroup, sensitivity analysis, and meta-regression was performed along with certainty assessment using grading of recommendations assessment, development and evaluation (GRADE). Results Thirteen studies (10 randomised trial and 3 pre-post studies) involving adults (mean age ranging from 45 to 65 yr) with hypertension, diabetes, stroke, and overweight were included in systematic review and 9 studies were included in meta-analysis. The CHW-led intervention significantly reduced systolic blood pressure (n=7,114; MD -5.5 mm Hg, 95% CI -9.0 to -1.9; P=0.041; I2=79.3%), with higher effect among people with hypertension (MD -7.5 mm Hg) and body mass index (MD -0.63 kg/m2; P=0.038) in intervention group. No significant change was observed in diastolic blood pressure, fasting blood glucose, glycated haemoglobin, and lipid profiles. Sensitivity analysis revealed no differential effect, and meta-regression showed no significant covariates. GRADE certainty of evidence was low to very low for outcome variables. Interpretation and conclusions CHW-led interventions in an Indian community setting showed beneficial effect on cardiometabolic outcomes, particularly blood pressure and body mass index, though the strength of evidence ranged from weak to moderate.

PMID:
42555695
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

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