With shortages of qualified human resources for health in low-income sub-Saharan African countries with high HIV/AIDs prevalence, there has been an increased interest in CHWs. This article examines whether present CHW programs supporting antiretroviral treatment in sub-Saharan Africa are taking into account lessons learned from past experiences and to what extent they are capitalizing on opportunities for improvement.
This analysis covers a 7-year interrupted time series that investigated early access to care and under-five morality during a proactive community case management intervention in periurban Mali. Prevalence of febrile illness in children under 5 years went from 39.7% to 22.6% in 7 years. Early antimalarial treatment more than doubled for young children under 5. Under-five mortality lowered to 7/1000 in 2015.
This cross case analysis of leadership and governance roles involved in implementing large-scale community health worker programs at sub-national level. The authors identified four key roles for leaders and governments in implementing these programs.
This cluster randomised controlled trial looked at the ability to train CHWs in Malawi to identify individuals with ear and hearing disorders. The intervention and training were effective and could be scaled up to CHWs in other countries.
This paper investigates the effect of expanding the population coverage of evidence-based interventions that community health workers provide outside of facilities. Using the Lives Saved Tool, the authors examined 73 countries and estimated that, if population coverage was expanded to 90%, 6.9 million lives of mothers and their children under the age of 5 could be saved during the period from 2016 to 2020.
In 2010, Zambia created a cadre of community health workers called Community Health Assistants (CHAs). This program continues to be scaled up to meet the needs of Zambia’s rural population. This study summarizes the factors that have aided the scale-up of the CHA program as well as the challenges. The study determined that CHAs play a critical role in providing a wide range of services to community members. However, CHAs continue to face challenges such as infrequent supervision, lack of medical and non-medical supplies, and challenges with the mobile data reporting system. The study c
This report is the first National Community Health Strategy Malawi has produced, spanning from 2017 to 2022. This strategy is intended to work towards achieving Millennium Development Goal number three: universal health care. The main focus of this strategy include: integration of health services, community engagement, and sufficient and equitable distribution of well-trained community health workforce. Efforts will also support maintaining sufficient supplies, transportation, and infrastructure. This strategy provides a guide and framework to introduce community health into the pre-exi
To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care.