In an attempt to address a complex disease burden, including improving progress towards MDGs 4 and 5, South Africa recently introduced a re-engineered Primary Health Care (PHC) strategy, which has led to the development of a national community health worker (CHW) programme. The present study explored the development of a cell phone-based and paper-based monitoring and evaluation (M&E) system to support the work of the CHWs.
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.
Community health worker (CHW) programmes are currently being scaled-up in sub-Saharan Africa to improve access to healthcare. CHWs are often volunteers; from an economic perspective, this raises considerations whether reliance on an unpaid workforce is sustainable and how to appropriately cost and value the work of CHWs. Both these questions can be informed by an understanding of CHWs’ workload, their opportunity costs of time and the perceived benefits of being a CHW. However, to date few studies have fully explored the methodological challenges in valuing CHW time.
In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs.
Despite the progress some countries have made in scaling up CHW programs, many countries that would benefit from strong CHW cadres currently have only ad hoc, sub-scale programs. This problem extends even to high-income countries that would benefit from CHW programs to provide cost-effective care and battle chronic disease. Countries wishing to scale these programs using a coordinated national strategy face many challenges.
The Community Tool Box is a free, online resource for those working to build healthier communities and bring about social change. Our mission is to promote community health and development by connecting people, ideas, and resources.
The Tool Box consists of 46 chapters with topics ranging from community assessment to strategic planning to leadership and management. Each chapter also contains a related toolkit that can be utilized by your organization or used as a teaching tool.
This report from the One Million Community Health Workers (1mCHW) Campaign on the outcomes from its 2015 workshop, Financing Community Health Worker Systems at Scale in Sub-Saharan Africa, shows that there is a timely opportunity to invest in government-led scale-up of community health worker programs in sub-Saharan Africa.
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.
There is robust evidence that community health workers (CHWs) in low- and middle-income (LMIC) countries can improve their clients’ health and well-being. The evidence on proven strategies to enhance and sustain CHW performance at scale, however, is limited. Nevertheless, CHW stakeholders need guidance and new ideas, which can emerge from the recognition that CHWs function at the intersection of two dynamic, overlapping systems – the formal health system and the community. Although each typically supports CHWs, their support is not necessarily strategic, collaborative or coordinated.
In recent years, community health workers (CHWs) have received renewed attention in light of critical shortages in the health workforce and emphasis on strengthening primary healthcare systems for achieving global health goals. CHWs are generally assumed to be a less expensive alternative compared with other cadres of health workers, notably with regard to salary and incentives as well as training costs. In parallel, more and more evidence has accumulated in recent years on the effectiveness of CHWs in delivery of essential health services in low- and middle-income countries (LMICs).