Volunteer community health workers (VCHW) are health care providers who are trained but do not have any professional certification. They are intended to fill the gap for unmet curative, preventative, and health promotion health needs of communities.
In the Ugandan context CHWs are given the collective name of Village Health Teams (VHTs). The national health policy in Uganda recognizes VHTs as constituent part of the health care system. VHTs in Uganda are assigned various tasks ranging from health education to dispensing of allopathic medicines.
Community health workers (CHWs) can play important roles in primary health care delivery, particularly in settings of health workforce shortages. However, little is known about CHWs’ perceptions of barriers and motivations, as well as those of the beneficiaries of CHWs. In Rwanda, which faces a significant gap in human resources for health, the Ministry of Health expanded its community health programme beginning in 2007, eventually placing 4 trained CHWs in every village in the country by 2009.
A paucity of skilled health providers is a considerable impediment to reducing maternal, infant, and under-five mortality for many low-resource countries. Although evidence supports the effectiveness of community health workers (CHWs) in delivering primary healthcare services, shifting tasks to this cadre from providers with advanced training has been pursued with overall caution—both because of difficulties determining an appropriate package of CHW services and to avoid overburdening the cadre.
This document provides guidance and resources for implementing recommendations to integrate community health workers (CHWs) into community-based efforts to prevent chronic disease. After providing general information on CHWs in the United States, this document sets forth evidence demonstrating the value and impact of CHWs in preventing and managing a variety of chronic diseases, including heart disease and stroke, diabetes, and cancer.
The World Health Organization (WHO) estimates that approximately 500,000 children each year are diagnosed with tuberculosis (TB) and 64,000 HIV-negative children die annually due to TB. The true burden of childhood TB is unknown; children are often undiagnosed and therefore do not receive appropriate care. Childhood TB is often seen with other common childhood illnesses such as HIV/ AIDS, pneumonia and malnutrition, and should be considered in sick children, particularly in areas of high TB burden.
Community health worker (CHW) programmes have received much attention since the 1978 Declaration of Alma-Ata, with many initiatives established in developing countries. However, CHW programmes often suffer high attrition once the initial enthusiasm of volunteers wanes. In 2002, Uganda began implementing a national CHW programme called the village health teams (VHTs), but their performance has been poor in many communities. It is argued that poor community involvement in the selection of the CHWs affects their embeddedness in communities and success.
A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh’s pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women’s choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities.
In this commentary, we discuss a photography competition, launched during the summer of 2014, to explore the everyday stories of how gender plays out within health systems around the world. While no submission fees were charged nor financial awards involved, the winning entries were exhibited at the Global Symposium on Health Systems Research in Cape Town, South Africa, in October 2014, with credits to the photographers involved. Anyone who had an experience of, or interest in, gender and health systems was invited to participate.
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.