In 2005, a three-year multi-country study was launched to examine how the Community Directed Intervention (CDI) approach, which had been remarkably successful in distributing ivermectin for treatment of onchocerciasis, could be used alongside ivermectin for integrated delivery (or co-implementation) of four other health interventions: Vitamin A supplementation, distribution of insecticide-treated nets, directly observed treatment, short course (DOTS) for tuberculosis and home-management of malaria. The study covered a total of 2.35 million people.
In response to widespread recognition of the need to scale up community health workers as a part of primary health systems in sub-Saharan Africa, this technical report was prepared to consolidate scientific and implementation experience in a series of recommendations and guidelines. This technical taskforce report focuses on providing broad cost guidance, deployment strategy and operational design considerations for CHW subsystems as part of health system strengthening to achieve the MDGs.
This guide outlines the type of information and approaches that Healthy Villages managers could provide to their communities; it can be used as the basis for developing material that is specific to regions or to entire countries. Healthy Villages deals with achieving good health through: water, excreta disposal, drainage, solid waste management, housing quality, hygiene, providing health care, and establishing committees for implementing Healthy Villages Initiatives.
This article presents a model for the development of sustainable primary health care in village communities in Honduras through the training and support of CHWs. The model, piloted in Comayagua, follows a "bottom-up" approach. A training curriculum for CHWs was developed that addressed the area's predominant health problems and made use of "Where there is no doctor" Training, a medical kit and quarterly support visits were provided to CHWs. After 15 months of practice, CHWs had attended to 2,347 patients.
This paper reviews recently published literature on community health worker programs, primarily focusing on maternal and newborn child health. Eighteen CHW programs and eleven relevant articles were included. It identifies key components of successful CHWs programs, reviews past successes and failures of CHW program implementation and summarizes important lessons learned.
This article looks at the policy landscape and processes that led to the implementation of a community case management (CCM) for child survival program in Nicaragua. The authors review both the contextual factors that facilitated CCM as well as the challenges, and conclude that continuous monitoring is essential for both sustainability and scale up.
This article reviews Iran’s “Health Houses,” which were conceived and introduced during the country’s 1980-1988 war with Iraq. The health houses are run by trained CHWs, called behvarzan, who provide basic health care to most of the country's rural population. Female behvarz are typically responsible for child and maternal health, vaccinations, registration and administering medicines, while male behvarz deal mainly with sanitation and environmental projects. An estimated 90% of Iran's rural population receives health care at its 17,000 health houses from 30,000 CHWs.
This report summarizes six guiding principles and lessons learned that emerged from the work of an MOH/BASICS team developing a community-based IMCI program in Madagascar. The principles elaborated for streamlining community-based programs are: 1. Action-based messages; 2. Easy-to-use front-line teaching tools; 3. Short skill-based trainings; 4. Engaging large numbers of volunteers; 5. Mass media support; and, 6. Celebrating achievement.
This article reports on the important contributions of community health volunteers in the success of primary health care in Thailand. More than 800,000 health volunteers, including Buddhist monks and their temples, work to promote primary health care and health promotion across the country.
This study sought to identify best practices in deployment of community health and care workers (CHWs and CCWs). Studies conducted in each of South Africa’s 9 provinces assessed the extent to which CHW deployment has addressed important health priorities; documented success stories and lessons; and developed an understanding of the range of ways that CHW programs have evolved in the country.