To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care.
Results from the United States Agency for International Development (USAID)-funded Family Advancement for Life and Health project (FALAH), implemented from 2008-2012, show that the inclusion of men in family planning (FP) efforts is a feasible and effective intervention to help shift attitudes and behaviours in Pakistan and perhaps in other countries in the region and globally as well. This brief presents findings of a case study of FALAH's male engagement component and its contributions to these results.
Mobile health, or “mHealth”, seeks to address the use of mobile technology to provide health services and information. Due to the increased risk in a child’s life during those weeks after birth, mHealth technologies can be utilized through referral and tracking of mothers and infants, decision support for CHW, CHW supervision, scheduling and tracking postpartum and postnatal visits, and teaching and counseling for mothers and families, among other uses. These case studies from Afghanistan, India, Malawi, and Indonesia reflect some of these uses.
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.
This full version of a previous feature goes into detail about CHWs and mental health. CHWs encounter psychosocial issues on a daily basis, but their training does not cover this area. This paper discusses the role CHWs can potentially fill in regards to mental health care, the evidence showing the effectiveness of such care, and World Vision’s approach to training CHWs in mental health care issues.
Tuberculosis is one of the leading causes of death throughout the globe, though treatment exists and is effective. In order to combat drug resistant tuberculosis, community-based directly observed treatment (DOT) is recommended by the World Health Organization, in which a supervisor observes the patient swallow their anti-tuberculosis medication. While highly praised, this method has been inconsistent in the past. This study looked at the effectiveness of community-based DOT for tuberculosis treatment.
Care Group projects resulted in high levels of healthy behavior, including use of oral rehydration therapy, bed nets, and health care services. Accordingly, under-5 mortality in Care Groups areas declined by an estimated 32% compared with 11% in areas with child survival projects not using Core Groups.
Care Groups use volunteers to motivate mothers to adopt key MCH behaviors. The volunteers meet as a group every 2-4 weeks with a paid facilitator to learn new health promotion messages. Key ingredients of the approach include: peer-to-peer health promotion, selection of volunteers by the mothers, a manageable workload for the volunteers (no more than 15 households per volunteer), frequent (at least monthly) contact between volunteers and mothers, and regular supervision of the volunteers.
Demonstrating that a health service, such as providing contraceptive implants, can be safely task shared to less highly trained workers is crucial but is only one step toward effective implementation at scale. Providers need dedicated time, enough clients, supplies, supervision, and other system support, allowing them to maintain their competency, confidence, and productivity.
Globally, 2.5 billion people are “unbanked,” lacking access to formal financial services. As a result, roughly one third of the world’s population is forced to rely on cash transactions or informal financial systems, which can often be unsafe, inconvenient, and expensive. Among the unbanked, however, a billion have access to a mobile phone, and mobile-based financial services are quickly closing the financial access gap.