This systematic review analyses the research undertaken with respect to India’s accredited social health activist (ASHA) scheme as the programme enters its second decade. The review focused on whether the programme has suitable health systems interfaces to ensure sustainability and areas to focus upon as the programme evolves.
Since 2003, Ethiopia has been implementing a community health extension program (HEP). This systematic review assesses the improvements that the program has brought about particularly in terms of maternal and childcare, hygiene and sanitation, knowledge and healthcare seeking. It also looks at the weaknesses of this dynamic program with respect to productivity, efficiency, capacity and living conditions of health extension workers (HEWs).
To support quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix tool. This tool can be applied at district, regional, and national levels to identify and close gaps in design and implementation and, ultimately, enhance program performance.
Retaining CHWs is essential in the sustainability of CHW programs; yet, there is little literature on reasons for their attrition that might help CHW retention. This study measured CHW attrition and its predictors in a rural area in Kenya.
Sustainable funding is a significant barrier to expanding CHW work and to CHW integration into the healthcare system. This brief examines how states can use Medicaid managed care contracts to support community health workers.
Why don’t more patient-centered medical homes (PCMHs) employ CHWs despite the evidence that they make a difference? This qualitative study researched facilitators and barriers to integrating CHWs in PCMHs in Minnesota and defines the roles of CHWs on these care teams. The study found four factors that influenced use of CHW models :1) leaders who championed the CHW model, 2) a clinic culture that was open to innovation; 3) clinic prioritization of patients’ nonmedical needs, and 4) leadership perceptions of sustainability.
This article presents findings from a study of treatment of uncomplicated severe acute malnutrition by community health workers in rural Mali. Key findings indicate that well-trained and supervised CHWs are capable of managing cases of uncomplicated SAM, there is an opportunity to increase access to quality treatment in Mali for SAM, and that resources needed to ensure continuous service should be further explored.
This study assessed whether or not community health workers maintain competency in malaria rapid diagnostic tests (RDTs) administration over a twelve-month period as well as the CHW characteristics, such as age or level of experience, that influence competencies. The results indicate that a majority of CHWs maintain RDT competency over at least a twelve-month period and that younger age and prior experience with RDT are associated with better RDT performance.
This study examines Community Health Workers’ perceptions of how the Zimbabwe study for Enhancing Testing and Improving Treatment of HIV in Children (ZENITH) randomized controlled trial’s structure and management affected their performance. The results of the study showed that CHWs saw the intervention as acceptable, feasible, and expressed overall strong job satisfaction. Long term sustainability of the programme is highlighted as an issue and the future improvement and adoption of the approach in other settings are discussed.