This article reviews Iran’s “Health Houses,” which were conceived and introduced during the country’s 1980-1988 war with Iraq. The health houses are run by trained CHWs, called behvarzan, who provide basic health care to most of the country's rural population. Female behvarz are typically responsible for child and maternal health, vaccinations, registration and administering medicines, while male behvarz deal mainly with sanitation and environmental projects. An estimated 90% of Iran's rural population receives health care at its 17,000 health houses from 30,000 CHWs.
This article reports on the important contributions of community health volunteers in the success of primary health care in Thailand. More than 800,000 health volunteers, including Buddhist monks and their temples, work to promote primary health care and health promotion across the country.
This study assessed the first year of Ethiopia’s Health Extension Worker (HEW) training program, a central component of the Health Extension Program's (HEP). The authors used a questionnaire and observations on the training program’s inputs, processes, and outputs. They found that the training centers lacked adequate facilities for the HEW trainees and the selection and training processes were flawed. However, trainees expressed a high level of commitment. The authors make recommendations on improving future training, continuing education of HEWs, and dealing with attrition.
This article reports on a study assessing the performance of CHWs in the promotion of basic child health services in rural Mali. The study was conducted as a community based cross-sectional survey. Data were collected from 401 child caregivers and 72 CHWs. Analysis showed a positive influence of CHWs on family health practices. The authors conclude that providing continuous training, transport, adequate supervision and financial incentives to CHWs are among key factors to improve the work of CHWs in rural communities.
This article profiles CHWs, including health promoters, traditional birth attendants and traditional healers, serving rural Quechua communities from Ayacucho, Peru. It uses both quantitative and qualitative information from questionnaires, personal interviews and group discussions conducted in 40 communities. The majority of CHWs in Ayacucho are men with limited education who are primarily Quechua speakers. However, health promoters were typically young and high school graduates, while traditional healers and birth attendants were generally older and illiterate.
This article from the Bulletin of the WHO, describes various roles played by Accredited Social Health Activists (ASHAs), India's national cadre of village-based workers, and other innovative community health programs working on maternal and child health, sanitation and hygiene, contraception, immunization and other health issues. CHWs are making major contributions to national efforts to reduce health inequalities and address social conditions that threaten the population’s health and access to care.
This article describes a qualitative study that examines the efficacy of non-financial incentives in sustaining volunteerism among CHWs. The study addresses: the motivation of volunteer CHWs; barriers and de-motivating factors; the effectiveness of non-financial incentives; and the mechanisms by which incentives motivate volunteer CHWs. The study also explores the role of community anchors or local institutions in sustaining volunteerism among CHWs.
The South African Academy of Family Practice's Rural Health Initiative journal details their delegation's visit and observation of the rural primary health care network in Iran. They examined in particular the roles of different workers in the Iranian system and the health houses that are staffed by CHWs, known locally as, Behvarz. The health houses are responsible for: maternal and child health, TB, Malaria, mental health, chronic illnesses, symptomatic treatment, environmental health and occupational health.
This journal article looks at a study conducted in 2007 to evaluate the impact of community directed intervention (CDI) on delivering five health interventions in onchocerciasis endemic districts in Tanzania: Vitamin A supplementation (VAS), community-directed treatment with Ivermectin (CDTi), distribution of insecticide -treated nets (ITN), directly observed treatment of TB (DOTS), and home-based management of Malaria (HMM).
This article examines Directly Observed Therapy (DOT-HAART) provided by CHWs or accompagnateur to HIV patients in Boston and Haiti. The CHWs provide psychosocial support and link the patients to clinical staff and available resources. The article suggests that the accompagnateur model can be applied to other poverty-stricken populations in resource-poor settings.