Video Spotlight

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

Karin Källander, Daniel Strachan, Seyi Soremekun, Zelee Hill, Raghu Lingam, James Tibenderana, Frida Kasteng, Anna Vassall, Sylvia Meek and Betty Kirkwood

Scaling up interventions that increase access to timely and appropriate treatment at the community level could prevent more than 60% of these deaths. As a way of increasing access to treatment for sick children, several African countries are investing in community health workers (CHWs) as a cost-effective way of extending health services to people living beyond the reach of the health facilities. Integrated community case management (iCCM) is a delivery strategy that utilises CHWs to diagnose and treat multiple conditions, most commonly pneumonia, diarrhoea and malaria, in children under five. If properly trained, equipped and utilised, CHWs have the potential to reduce child deaths substantially by increasing access to timely, appropriate and affordable treatment for poor and rural populations.

CHW programmes have been faced with the challenge to scale up with high CHW attrition rates and substandard care quality. This has largely been due to problems with poor planning; fragmented and disease-specific training; tenuous linkage to the health system; poor coordination, supervision and support; and under-recognition of CHWs’ contribution to the health system. If CHW programmes are to reach their potential, there is an urgent need for strategies that improve performance, motivation and retention of CHWs. 

This paper presents a protocol for a cluster randomised controlled trial (cRCT) conducted under the inSCALE project (Innovations at Scale for Community Access and Lasting Effects). inSCALE aims to enhance the motivation and performance of CHWs in order to ultimately increase the coverage of children who receive appropriate treatment for diarrhoea, pneumonia and malaria in Uganda and Mozambique. 


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