In 2018, three global healthcare quality reports were published which resolutely move the UHC discourse from coverage to quality but fail to extend this to the quality of community health worker (CHW) programmes. Late in 2018, the WHO released its guidelines for optimising CHW programmes and health systems, in line with the renewed global focus on primary health care and community health workers as critical to achieving UHC.
How will we address the predicted worldwide shortage of over 14 million health workers by 2030? At the World Economic Forum in Davos Switzerland in 2015, a 4-year US$100 million fund supporting Last Mile Health and Living Goods to train 50,000 CHWs in six countries was launched. This commentary details the goals and challenges of such an initiative.
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.
As access to mobile technologies expands, improving their effective use is key to strengthening data. This article discusses emerging lessons from rural Rwanda on CHW use of mobile technologies for health interventions. Technical characteristics such as reminders and alerts were seen to be the strongest predictors towards use, while user characteristic (age) did not influence use. Programme characteristics, specifically supervision and training, had mixed findings.
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.
This study examines how Brazilian primary health care handles domestic violence against women. A gap between policies and practical application were found at local levels and community health workers were found to be critical to opening dialogue between women experiencing violence and the health care system.
This paper discusses the role of community health workers in realizing the right to clean air. Nepal is used as an example of a human rights-based approach to address the issue of indoor air pollution.