In Zimbabwe Dixon Chibanda, a psychiatrist, created a space called “Friendship Benches” that sets aside medical and technical elements of mental healthcare and engages the community through “grandmothers” or local lay health workers. The grandmothers are trained in a form of cognitive behavioral therapy, but engage their patients in local language which helps reduce stigma associated with mental health in the community. This program was created to address the overwhelming lack of mental healthcare workers in the country. Thus far, the program has reached over 30,000 Zimbabweans. Studies
This document provides a summary of the key points during the “Unlocking the community health workforce potential, post-Ebola: what models and strategies work” meeting. This meeting was designed to develop strategies for countries affected by Ebola and to share lessons from countries with strong existing community health systems. Needs of these countries were shared in an effort to align with global efforts to support effective CHW programs. This meeting drew on both public and private sector leaders in an effort to share knowledge while keeping CHWs at the center of stakeholder thinking
Post Ebola, Guinea is rebuilding its health system to deliver higher quality care. Part of their effort includes gaining trust again from the community, something that dwindled during the epidemic. Health Communication Capacity Collaborative (HC3) is a five year initiative funded by USAID that is working to address these concerns. HC3 utilizes a social and behavior change communication (SBCC) strategy to improve health behaviors and services in Guinea.
Lochuch, a CHW in Kenya, faces many challenges in her job as she tries to protect the health of those in her community. She has dealt with angry husbands and ambulance denials; actions that could lead to harm of pregnant women. Lochuch is working to ensure that women can deliver in a hospital. This article details her personal experience overcoming barriers in her community and the resilience with which she and her co-workers advocate for their clients.
Kenya does not have a strong health infrastructure to support its people causing concern with current universal healthcare goals. Kenya worries it will not be able to deliver care without a strong CHW program such as Rwanda’s. Although Kenya already has CHWs working in certain areas, they are overwhelmed with large numbers of families per CHW and are not able to provide adequate care to everyone. This article cites Rwanda’s success with a larger CHW program and results of significantly better health, pushing for Kenya to do the same.
In Ethiopia some CHWs are now receiving smartphones that aid them in providing care for patients as well as strengthening new skills they can use in their job. This technology is powered by a solar lantern that allows CHWs to use training modules at home that can be downloaded and used without connection. In addition, the lantern provides a source of light to study CHW textbooks at night. These resources have increased exam scores of CHWs and helped them feel better prepared to help those in their community.
This article draws on the importance of CHWs in post conflict countries. Sidibe details personal experience in East Timor where he worked as a Peace Corps Volunteer, but emphasizes his new work in Liberia and the health improvements that have been made as a result of CHWs. Liberia and surrounding nations post Ebola were left with a lack of health resources posing a challenge to its people. With the support of the international community these countries are now establishing CHWs to help with preventative care in communities across the country.
In Zambia, the 2010 National Community Health Worker Strategy (NCHWS) created a cadre of salaried Community Health Assistants (CHAs) to work in rural and underserved areas providing access to health care and developing prevention measures. The Ministry of Health (MOH) is currently in the process of creating a workforce of 5,000 CHAs. After the first class of CHAs graduated, a process evaluation was conducted. This study is the second evaluation of the program, which has since grown due to results of the first evaluation. The goal of this study was to evaluate long-term needs of a large-
This study on child survival, presents indicators, national document, and qualitative data from key informants and community women describing the factors that have enabled Zambia to successfully reduce under-five mortality over the last 15 years and achieve Millennial Development Goal (MDG) #4. Study results found a Zambian national commitment to ongoing reform of national health strategic plans and efforts to ensure universal access to effective maternal, neonatal and child health (MNCH) interventions, creating an environment that has promoted child health.
The objective of this paper was to assess if training Health Surveillance Assistants (HSAs) in couples counseling would increase modern family planning uptake among young women in Malawi. In this cluster randomized controlled trial, 30 HSAs from Lilongwe, Malawi received training in family planning. The HSAs were then randomized 1:1 to receive or not receive additional training in couples counseling. All HSAs were asked to provide family planning counseling to women in their communities and record their contraceptive uptake over 6 months.