To support quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix tool. This tool can be applied at district, regional, and national levels to identify and close gaps in design and implementation and, ultimately, enhance program performance.
The Community Health Systems (CHS) Catalog is a one-stop ‘shop’ for information on community health policies and programs across 25 countries, including extensive information on CHWs. Developed in 2014 and updated in 2017, it provides policymakers, program managers, researchers and donors with policy data to advance community health research, programming, and advocacy efforts. The CHS Catalog includes 25 country profiles, a set of infographics, and a summary of cross-country policy and program trends.
Based on qualitative research from six countries (Bangladesh, Indonesia, Ethiopia, Kenya, Malawi, Mozambique) that were part of the REACHOUT consortium, this study explores how gender roles and relations affect close-to-community (CTC) health service provider experience at the individual, community, and health system levels.
This study investigate the impact of two umbilical cord cleansing regimens on neonatal morality and morbidity in a rural region in the Sylhet District of Bangladesh. The study used data from a previously performed community-based cluster-randomized trail. Community health workers checked the newborns for the first nine days of life for infections. The authors found that identifying and following up with high-risk mothers and newborns along with clean cord care can decrease the rate of neonatal infections and deaths.
This resource from USAID and MCHIP provides an overview of large-scale CHW programs from 13 countries: Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia, Iran, Nepal, Niger, Pakistan, Rwanda, Zambia and Zimbabwe. Case studies address the historical context of CHWs, the health needs of the country, the scope of work of the CHWs, CHW training, support and supervision, and financing of CHW programs. The demonstrated impact and continuing challenges of the different programs are also addressed.
This longitudinal study aims to assess the effect of CHW-provided targeted education on blood pressure (BP) control in hypertensive patients in Bangladesh. Trained CHWs regularly followed up and provided specific health messages on BP control to adult hypertensive individuals through quarterly meetings and individual counseling. Mean BP changes were measured ever 6 months for 24 months. BP measurements showed that systolic BP and diastolic BP were significantly reduced compared to baseline in the group that worked with CHWs.
Due to deficiencies in low- and middle-income countries, policy makers are suggesting different methods to achieving universal health coverage. One strategy is the expansion of cadres of close-to-community providers, which plays an important role for connecting communities with the formal health sector. This poster from the Reachout Consortium identifies some of the challenges with this strategy and how to address quality-related issues for universal health coverage.
In order to get a better understanding of adolescent use of contraceptives in Bangladesh, researchers interviewed married adolescent girls, key informants, and CHWs. Main factors regarding the lack of contraceptive use among married adolescents include lack of health knowledge, communication ability, and mistrust towards contraceptive methods. CHWs played an important role in determining these factors as they are involved in healthcare delivery for these young girls and often positively influence use of contraceptive methods.
Using a newly developed case-management job aid based upon the WHO Integrated Management of Childhood Illness guide, community health care providers (CHCPs) in Bangladesh were trained to measure changes in knowledge. After the training, the CHCPs clearly improved their knowledge and provided better quality care to patients. Results from this study could be used to improve community health programs in other communities, particularly in those that are struggling with poor quality care.
USAID's 2016 Acting on the Call Report provides updates from the program that aims to end preventable maternal and child deaths in 25 priority countries, which together accounted for more than two-thirds of child and maternal deaths worldwide.