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

Rebecca Furth and Lauren Crigler

The United Nations Millennium Project identified the large-scale training and deployment of community health workers (CHWs) as an important strategy for achieving the Millennium Development Goals (MDGs). However, programs involving CHWs are also known to be fraught with significant human resources challenges. The USAID Health Care Improvement Project (HCI) developed the Community Health Worker Assessment and Improvement Matrix (CHW AIM) to help assess CHW program functionality and to provide benchmarks against which to measure program improvements.

Zambia’s large number and wide range of CHWs and the government’s openness to CHWs and recognition of their value made Zambia an ideal country in which to conduct CHW AIM operations research. This research focused on CHWs supported by five different implementing partners in Zambia categorized as “community health volunteers” by the Zambian National CHW Strategy.

This study focused on three research questions:

  1. Does application of the CHW AIM tool contribute to CHW program functionality improvement?
  2. What is the relationship among program functionality, CHW engagement and CHW performance?
  3. What are the costs associated with implementing the CHW tool and what is the incremental cost effectiveness associated with its use?

This study was designed as a field intervention study. The CHW AIM process twice was applied at the beginning and end of a thirteen month intervention period. The sample included six organizations, five of which applied the CHW AIM process, and 157 CHWs. Researchers collected data using an engagement survey complemented by in-depth interviews and other instruments to collect a variety of qualitative and quantitative data. Service delivery was assessed through audio recordings and the study team collected additional data on program design, results, and costs.

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Initiatives Inc.
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