Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Matthew Harris

Prabhjot Singh and Jeffrey Sachs' Viewpoint (July 27, p 363) describes well the rationale for scaling-up a subsystem of community health workers (CHWs) in sub-Saharan Africa and the progress to date.
It is well recognised that CHWs can bring multiple benefits to individuals and populations, and improve efficiency and equity within health systems. WHO now recommends an expanded CHW role. What is less well recognised is that such a system is applicable to all WHO member states.
CHWs signpost patients to services, proactively identify health-care and social-care problems at the household level, provide low-level health promotion advice, improve communication with primary care services, and gather important sociodemographic data from their micro-areas. This is valuable for any health system.
It seems increasingly important that lean innovations, developed in or for resource-poor settings, be considered seriously in rich countries. There is an emerging field of health-care reverse innovation—simple low cost solutions that draw on innovations from developing countries. It is much harder, however, to identify initiatives in developed countries that explicitly draw on such innovations, although some examples exist. Whether this is due to barriers to innovation diffusion, or post-colonial double standards, is worthy of examination.

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