Care Group projects resulted in high levels of healthy behavior, including use of oral rehydration therapy, bed nets, and health care services. Accordingly, under-5 mortality in Care Groups areas declined by an estimated 32% compared with 11% in areas with child survival projects not using Core Groups.
Care Groups use volunteers to motivate mothers to adopt key MCH behaviors. The volunteers meet as a group every 2-4 weeks with a paid facilitator to learn new health promotion messages. Key ingredients of the approach include: peer-to-peer health promotion, selection of volunteers by the mothers, a manageable workload for the volunteers (no more than 15 households per volunteer), frequent (at least monthly) contact between volunteers and mothers, and regular supervision of the volunteers.
Demonstrating that a health service, such as providing contraceptive implants, can be safely task shared to less highly trained workers is crucial but is only one step toward effective implementation at scale. Providers need dedicated time, enough clients, supplies, supervision, and other system support, allowing them to maintain their competency, confidence, and productivity.
This guide aims to help policymakers and program managers assess whether engaging communities makes sense in the context of the performance-based incentive (PBI) programs they support; determine what is the best approach or mechanism for such engagement; and how to mitigate the risks. PBI, as with bottom-up social accountability mechanisms, aims to fix broken accountability relationships by providing payers of health services tools to hold providers accountable through provision of incentives for verified increases in the quantity and quality of health services.
During the past 10 years, community health workers (CHWs) have emerged as a focal point of international discussions on primary health-care systems. Although lay community-based health workers have been active for at least 60 years, the Millennium Development Goals (MDGs) in 2000 prompted new discussion of how these workers can help to extend primary health care from facilities to communities. CHWs have since been part of an international attempt to revise primary health-care delivery in low-income settings, and CHW programmes have been changed accordingly.
Community health workers (CHWs) are an increasingly important component of health systems and programs. This study was conducted to determine the impact of supervision strategies used in low- and middle- income countries and discuss implementation and feasibility issues with a focus on CHWs.
Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs.