The level of deprivation and structural inequality within the community was a contributory factor to dietary choice, with financial barriers cited as the major reason why families from deprived neighbourhoods were unlikely to buy fresh food.
However, AD is a complex inflammatory disease, and human-associated microbial communities may be a contributory factor.
To capitalise fully on the communities' ability to play a contributory role in durably scaling up ART, a supportive policy environment and an enabling regulatory framework are needed to drive the implementation of task-shifting policies and to resource, guide and support these lay CHWs [ 55, 74].
However, an extensive literature review has demonstrated that – to date – little systematic scientific research has been performed on the contributory role of these community support and expert patient structures in HIV/AIDS treatment programmes and the health system at large in resource-limited countries [ 20, 31].
Conversely, high job demand as described by community health workers may also be a contributory factor for lower intrinsic job satisfaction (i.e. the feeling of accomplishment from the job) and extrinsic job satisfaction (i.e. pay and the amount of work) [ 34].
In a multi-country stakeholder perspective study (44) and another study in rural Nigeria (45), both on the retention of lay health workers in rural communities, support by community health committees was identified as an important contributory factor to retention.
The dearth of scientific evidence on the contributory role and function of these forms of community mobilization renders a formal evaluation and scientific review of the published results of existing community support and expert patient programmes a clear research priority.
The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority.
The Covenant does not restrict the form of the scheme, and both contributory and non-contributory schemes are permissible (as are community-based and mutual schemes).
A review of the literature (Table 1) on the association between community support and ART programme outcomes clearly indicates that the community can have a contributory role in scaling up ART in resource-limited settings [ 20, 23, 41, 42, 45, 47, 48, 50, 52, 53, 62, 68].
