This paper explores the factors that shaped the acceptability and adoption of community health assistants (CHAs) into the health system at the district level in Zambia. Using thematic analysis, data was collected through a review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team. Results found a perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities.
This review explores the current evidence available to assess if increased levels of integration of community health resources in CHW programs leads to higher program effectiveness and sustainability. 32 articles were chosen for an extensive review, complemented by analysis of the results of 15 other review studies. Analysis found no quantitative data and minimal inclusion of even basic community level indicators.
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 paper assesses the change in the use of essential maternal and child health services in Konobo, Liberia after the implementation of an enhanced CHW program. Last Mille Health, a nongovernmental organization, partnered with the Liberian Ministry of Health to pilot the CHW program. The program had enhanced recruitment, training, supervision, and compensation. Researchers conducted cross-sectional cluster surveys before and after the program implementation.
This review article explores the various definitions and descriptions of CHWs in the literature. It also identifies common themes in these definitions to better understand the essential characteristics of health workers classified as CHWs and to distinguish them from other healthcare providers. By describing the various categories of CHWs, this resource helps to clarify the use of the term to ultimately aid key stakeholders in community health program planning, policy, and research.
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.
This publication aimed to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers.
Most countries in sub-Saharan Africa have now adopted integrated community case management (iCCM) of common childhood illnesses as a strategy to improve child health. In March 2014, the iCCM Task Force published an Indicator Guide for Monitoring and Evaluating iCCM: a ‘menu’ of recommended indicators with globally agreed definitions and methodology, to guide countries in developing robust iCCM monitoring systems. The Indicator Guide was conceived as an evolving document that would incorporate collective experience and learning as iCCM programmes them- selves evolve.
The community health framework is intended to support Ministries of Health in developing and strengthening programs for improved community health outcomes. The intention is for USAID missions and other advisors to use the framework to structure a dialogue, develop recommendations, and foster continuous learning with Ministries of Health. This presentation is a fantastic resource for understanding and supporting community health programs and networks.
Monitoring and evaluating large-scale global health program transitions can strengthen accountability, facilitate stakeholder engagement, and promote learning about the transition process and how best to manage it. This paper proposes a conceptual framework for 4 main domains relevant to transitions— leadership, financing, programming, and service delivery—along with guiding questions and illustrative indicators to guide users through key aspects of monitoring and evaluating transition.