Community health workers (CHWs) have been proposed as a means for bridging gaps in healthcare delivery in rural communities. Recent CHW programmes have been shown to improve child and neonatal health outcomes, and it is increasingly being suggested that paid CHWs become an integral part of health systems. Remuneration of CHWs can potentially effect their motivation and focus. Broadly, programmes follow a social, monetary or mixed market approach to remuneration.
“There continues to be a tremendous focus on enrolling people in treatment programs and ensuring that they remain in care. This case study examines an integrated clinical and social support program that used quality improvement, decentralization, task shifting, and community engagement to identify and address challenges to sustaining HIV treatment programs in India.”
Summer is winding down. Store shelves are stocked with notebooks and pencils instead of sunscreen and beach balls. And for most kids, the essential back-to-school purchase is the almighty backpack. If you're going to carry books and lunch to school, you'd better have something durable -- and fashionable! -- strapped on your shoulders.
CHW experiences in Orissa, India go beyond the technical aspects of combining different health systems. Teamwork and building trust with the community were found to be pivotal parts of their practice. The National Rural Health Mission (NRHM) primary health care ideology conflicts with the narrow indicators of health system performance (over reliance on statistical evidence, hierarchical bureaucratic, top-down structures) and impedes efforts towards health system integration.
A systematic review of published research was conducted in order to understand factors that may influence the integration of national community-based health worker (CBHW) programs into low- and middle –income countries. Four programs – Brazil, Ethiopia, India, and Pakistan – met the inclusion criteria and were integrated into their specific health systems. Several factors were included that facilitated the integration process, as well as other factors that inhibited the integration process.
This report outlines a series of workshops convened by mPowering Frontline Health Workers and partners to consider whether the global health community is following the most beneficial route to provide relevant and effective health training for FLHWs.
Unmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities.
This study examined the performance motivation of community health workers (CHWs) and its determinants on India's Accredited Social Health Activist (ASHA) programme. The inadequate healthcare delivery status and certain working modalities reduced their motivation. Gender mainstreaming in the community health approach, especially on the demand-side and community participation were the positive externalities of the CHW programme. The CHW programme could motivate and empower local lay women on community health largely.
This article presents an evaluation of the role of a link-worker trained in health promotion and aspects of chronic disease management. A shift in workload occurred from the practice nurse to link-worker, and there were improvements in asthma and diabetes care. A link-worker can be successfully trained to do traditional nursing tasks, which permits a change of role for the practice nurse and can have a beneficial effect on the processes of chronic disease management.
Community mobilisation through participatory women's groups might improve birth outcomes in poor rural communities. This study assessed this approach in a largely tribal and rural population in three districts in eastern India. The intervention group worked with a facilitator every month to support participatory action and learning for women, and facilitated the development and implementation of strategies to address maternal and newborn health problems. The primary outcomes were reductions in neonatal mortality rate (NMR) and maternal depression scores.