In 1978, the Alma-Ata declaration on primary health care (PHC) recognized that the world’s health issues required more than just hospital-based and physician-centered policies. The figure of the community health worker (CHW) remains a central feature of participation within the PHC approach, and being a CHW is still considered to be an important way of participation within the health system.
Pasa la Voz (spread the word) is a human immunodeficiency virus (HIV) prevention methodology inspired by respondent-driven sampling (RDS) that uses social networks to access hard-to-reach populations. As field testing showed the approach to be efficacious among at-risk women in West Texas and Southern New Mexico, we set out to evaluate the methodology in a Mexican context. A local community organization, Programa Compañeros, first implemented a traditional one-on-one outreach strategy using promotoras (outreach workers) in Ciudad Juarez, Mexico, from September 2005 to January 2006.
This presentation was delivered at the 4th Health Conference on Primary Health Care and Family Health in Brazil.
Building on an overview of the global health workforce challenges, Dr Sheikh outlined short-, medium - and long-term strategies to address health personnel shortages, and analysed the links between the HRH agenda and the revitalisation of primary health care. The potential contribution of community health workers was highlighted. Case studies from Brazil, Ethiopia and Pakistan were also presented.
In developing countries, where the density of trained physicians and nurses is low, community health workers (CHWs) are typically the primary and sometimes sole providers of healthcare to millions. However, studies have shown that even well motivated CHWs using paper-based job aids demonstrate less-than-desirable rates of treatment and diagnosis errors, and low protocol compliance.
Community Health Workers (CHWs) play a pivotal role in primary care, serving as liaisons between community members and medical providers. However, the growing reliance of health care systems worldwide on CHWs has outpaced research explaining their praxis – how they combine indigenous and technical knowledge, overcome challenges and impact patient outcomes. This paper thus articulates the CHW Praxis and Patient Health Behavior Framework.
Participation of community health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals.
This qualitative study evaluated the role of CHWs in the health system in both HIV and non-HIV-related services in rural Haiti and investigated the challenges and facilitating factors for their work. CHWs contributed to a wide range of primary health services and non-HIV related activities. Recognition from the community, status, satisfaction of contributing to the well-being of others and remuneration were facilitating factors for performing their work.
This report aims to identify CHW programs with positive impacts on Millennium Development Goals (MDGs), related to health or otherwise, through a global systematic review undertaken of such interventions, as well as eight in-depth country case studies in SubSaharan Africa (Ethiopia Mozambique and Uganda), South East Asia (Bangladesh, Pakistan and Thailand) and Latin America (Brazil and Haiti).
This paper examines various incentives used to motivate and retain community health workers, particularly those working in child health and nutrition programs in developing countries. Drawing from case studies in Afghanistan, El Salvador, Honduras and Madagascar, the authors recommend a more systematic use of multiple incentives based on an understanding of the different functions of the various incentives. It also emphasizes the importance of the CHW-community relationship.
This article presents a model for the development of sustainable primary health care in village communities in Honduras through the training and support of CHWs. The model, piloted in Comayagua, follows a "bottom-up" approach. A training curriculum for CHWs was developed that addressed the area's predominant health problems and made use of "Where there is no doctor" Training, a medical kit and quarterly support visits were provided to CHWs. After 15 months of practice, CHWs had attended to 2,347 patients.