Despite decades of experience with community health workers (CHWs) in a wide variety of global health projects, there is no established conceptual framework that structures how implementers and researchers can understand, study and improve their respective programs based on lessons learned by other CHW programs. Engaging a large group of implementers, researchers and the best available literature, the 5-SPICE framework was refined and then applied to a selection of CHW programs. Insights gleaned from the case study method were summarized in a tabular format named the ‘5x5-SPICE chart’.
There is a growing movement among health care organizations to adopt the Community Health Worker (CHW) model into their system as a way to provide comprehensive care to patients and community members. At the same time there is uncertainty about how to implement the CHW model to achieve better patient outcomes, higher quality of care, and lower health care costs. With generous funding from the Lloyd A.
Research evaluating community health worker (CHW) programs inherently involves these natural community leaders in the research process, and often represents community-based participatory research (CBPR). Interpreting the results of CHW intervention studies and replicating their findings requires knowledge of how CHWs are selected and trained. There was inconsistent reporting of selection and training processes for CHWs in the existing literature. Common selection criteria included personal qualities desired of CHWs. Training processes for CHWs were more frequently reported.
Though a wealth of knowledge and evidence is available on key aspects of CHW programs, critical knowledge gaps remain. To enable the environment for increased evidence-based decision making at the country level, adequate emphasis must be placed on continuing to strengthen the evidence base for CHWs. This paper attempts to identify all CHW knowledge gaps and outlines recommendations for the way in which research should be conducted to enable greater benefit and utilization of results.
This paper, together with the Framework for Partners’ Harmonized Support, proposes complementary operational frameworks through which national and international partners may align their actions with the collective goal to normalize a cadre of community workers and collaborate toward integrated, harmonized program designs rather than competitive, siloed, and parallel interventions.
Fragmentation is one of the main challenges to successful and sustainable CHW scale-up - in terms of programming, the service delivery chain, and the multiplicity of public and private organizations, training, deploying and supporting CHWs. This paper proposes a set of generally agreed guiding principles to support countries and their partners in their efforts to:
The goal of this initiative is to provide a forum in which all these different strands of evidence, information, and public and private values can be discussed together, in a public and transparent process. The mission of the New England Comparative Effectiveness Public Advisory Council (CEPAC) is to provide objective, independent guidance on how information on comparative effectiveness can best be used across
New England to improve the quality and value of health care services.
The United Nations Millennium Project identified the large-scale training and deployment of community health workers (CHWs) as an important strategy for achieving the Millennium Development Goals (MDGs). However, programs involving CHWs are also known to be fraught with significant human resources challenges. The USAID Health Care Improvement Project (HCI) developed the Community Health Worker Assessment and Improvement Matrix (CHW AIM) to help assess CHW program functionality and to provide benchmarks against which to measure program improvements.
The Care Group Difference guide, developed by World Relief, explores the evidence base for the Care Group model, offers criteria to assist project managers in determining the feasibility of using this approach within their own programs, and provides a step-by-step guide for starting and sustaining care groups. A care group is a group of 10 to 15 volunteer, community-based health educators who regularly meet together with project staff for training, supervision and support.
This manual is a guide for non-governmental organizations carrying out child health programs to assess under-five mortality rates and evaluate programs using the CARE Group Model. By following this manual’s methodology to establish a Mortality Assessment for Health Programs (MAP) System, organizations can collect valid and precise information about vital events and detect statistically significant changes in under-five mortality rates over the life of a child health program.