The Patient Protection and Affordable Care Act (ACA) provides a policy framework to re-imagine a system of care that emphasizes health and wellness through new models of primary care and population health interventions. These new models offer the potential to deliver care services at a lower cost, to detect and treat disease earlier, to deploy data and technology to improve population health outcomes, and to address social and environmental conditions that impede efforts to improve health.
The purpose of this paper is to promote early and continuous causal thinking as decision makers design, implement, scale up, and evaluate CHW and other programs that are intended to positively affect the public’s health. The methods section describes how the generic CHW logic model was constructed, drawing explicitly on research in LMICs and the informed opinion of CHW experts with experience in these countries. The results section presents a graphic display of the model
Welcome to Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers (the CHW Reference Guide). This guide is a long and detailed volume that is not intended to be read from cover to cover but rather to be used as a document that can be referred to as specific issues or questions arise. In this sense, you will find some repetition. We have also tried to refer the reader to other chapters where appropriate because many topics and issues are covered in various ways in different chapters.
In the face of global health worker shortages, community health workers (CHWs) are an important health care delivery strategy for underserved populations. In Uganda, community-based programs often use volunteer CHWs to extend services, including family planning, in rural areas. This study examined factors related to CHW motivation and level of activity in 3 family planning programs in Uganda. DCE results showed that provision of a package including a T-shirt, badge, and bicycle was the program input CHWs preferred, followed by a mobile phone (without airtime).
Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality.
Community health workers (CHWs) have a key role to play if we are to achieve our ambitious goals to reduce child and maternal mortality globally. A wide diversity of CHW cadres have been established in many countries, both in the public sector and with nongovernmental organizations, yet several major challenges have emerged. Mobile phones can be transformative for community health workers (CHWs) in enhancing their influence and status and helping to solve practical problems.
Program planners work with promotoras (the Spanish term for female community health workers) to reduce health disparities among underserved populations. Based on the Role-Outcomes Linkage Evaluation Model for Community Health Workers (ROLES) conceptual model, we explored how program planners conceptualized the promotora role and the approaches and strategies they used to recruit, select, and sustain promotoras. Planners conceptualized the promotora role based on their personal experiences and their understanding of the underlying philosophical tenets of the promotora approach.
Community engagement and participation has played a critical role in successful disease control and elimination campaigns in many countries. Despite this, its benefits for malaria control and elimination are yet to be fully realized.
In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes.
The Patient Protection and Affordable Care Act (PPACA) affords opportunities to sustain the role of community health workers (CHWs). Among myriad strategies encouraged by PPACA are prevention and care coordination, particularly for chronic diseases, chief drivers of increased health care costs. Prevention and care coordination are functions that have been performed by CHWs for decades, particularly among underserved populations. The two key delivery models promoted in the PPACA are accountable care organizations and health homes.