Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Financing CHW Systems at Scale in sub-Saharan Africa: Workshop Report

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.

Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study

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.

Strategic partnering to improve community health worker programming and performance: features of a community-health system integrated approach

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.

Costs and cost-effectiveness of community health workers: evidence from a literature review

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).

Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV

There is limited evidence that interventions for depression and other common mental disorders (CMD) can be integrated sustainably into primary health care in Africa. We aimed to pilot a low-cost multi-component 'Friendship Bench Intervention' for CMD, locally adapted from problem-solving therapy and delivered by trained and supervised female lay workers to learn if was feasible and possibly effective as well as how best to implement it on a larger scale. (2011)

Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV

There is limited evidence that interventions for depression and other common mental disorders (CMD) can be integrated sustainably into primary health care in Africa. We aimed to pilot a low-cost multi-component 'Friendship Bench Intervention' for CMD, locally adapted from problem-solving therapy and delivered by trained and supervised female lay workers to learn if was feasible and possibly effective as well as how best to implement it on a larger scale. (2011)

Enhancing training of community health workers in DRC through effective management

Evidence of the need to scale up the number of frontline health workers in developing countries abounds throughout sub-Saharan Africa, as described in the recent post in this blog by Avril Ogrodnick of Abt Associates. Yet training new health workers is not sufficient, in itself, to sustainably address the crisis – governments must also invest in providing management support to harvest the full value of these trainings.

Make Recife Count: Adapt HRH to the UHC Agenda

Worldwide, there are severe shortfalls in the health workforce — not just in the quantity of doctors, nurses and other health workers, but in their management, performance and geographical distribution.

These shortfalls are particularly glaring in light of the global movement for universal health coverage, progress toward which will require a high-functioning workforce.

A Call to Scale-Up Community Health Workers

This post is co-authored with Sonia Sachs on behalf of the 1 Million CHW Campaign.

Public health officials and practitioners from around Africa and from international public and private organizations, businesses, and universities, met in Accra, Ghana June 9-11 to consider ways to scale-up the coverage of high-quality community health worker (CHW) systems in our countries to achieve universal health coverage (UHC). In the meeting they pledged to work together to speed the scale-up of CHW systems in sub-Saharan Africa, and issued the following urgent appeal.

Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries

A systematic review of published research was conducted in order to understand factors that may influence the integration of national community-based health worker (CBHW) programs into low- and middle –income countries. Four programs – Brazil, Ethiopia, India, and Pakistan – met the inclusion criteria and were integrated into their specific health systems. Several factors were included that facilitated the integration process, as well as other factors that inhibited the integration process.

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