By: Rebecca Furth, Initiatives Inc.
CHWs Highlighted at the 4th Global Forum on Human Resources for Health
Resources for Health took place in Dublin Ireland from 13-17 November, 2017. Several sessions specifically addressed CHWs and many others raised their importance in expanding health systems and ensuring equitable access to quality care. Read our blogs highlighting issues from the institutionalization of CHWs in national health systems to addressing the complex gender considerations that affect CHWs and their work.
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Taking the next step: capitalizing on evidence to develop national CHW programs
We know CHWs make a difference in expanding access to services and closing critical health gaps. The evidence exists to support their use and effectiveness and with political will and clear guidelines countries can successfully institutionalize CHWs in health systems. These were the key messages of the dynamic and informative panel of experts hosted by the WHO Global Health Workforce Network CHW Hub during its community based health worker session at the 4th Global Forum for Human Resources for Health in Dublin on Tuesday November 14th.
A systematic analysis of CHW program reviews shows that CHWs can significantly improve community health. The evidence indicates they contribute to reducing neonatal, infant and child mortality and morbidity; increasing vaccination coverage; improving maternal health; expanding the availability of malaria testing and the identification of presumptive TB cases; and providing effective HIV treatment and care, without a drop in service quality. While CHWs are capable of a wide variety of tasks, even complex ones, giving them too many tasks or not providing adequate enablers pushes them to make choices and compromise some services over others. Assigning CHWs some curative services, as opposed to prevention and education only, is more motivating for CHWs. Lack of remuneration is linked to higher CHW attrition, making the case for paying CHWs. Perhaps more importantly, CHWs are most effective when they are integrated into and supported by the health system as a whole.
WHO is in the process of compiling evidence-based guidelines for health policy and system support for community-based health worker programs, which they expect to be available by June 2018. The guidelines will provide policy makers and program managers the information they need to make informed decisions and build stronger community health worker programs in the context of an integrated and comprehensive approach to strengthen the health workforce and health systems.
The session also included an impassioned call for more action and greater political will in committing to CHW programs. It underscored how CHW work changes the lives of community members and contributes to improved health not just of individuals, but of nations. Drawing on the successes of other countries and a need to rapidly expand health service delivery to communities, Guinea is in the process of establishing a national community health program. The country is stressing the importance of community health workers in creating a viable and responsive health system and reallocating national resources to the interventions that stand to make the greatest benefit to the population’s heath.
The session brought together international policy makers, national leaders, civil society, academia and CHWs themselves to make the call for expanded CHW programs. As we move to compiling the evidence and developing guidelines, more countries will be in a position to heed this call and reinforce the community health workforce to meet community needs for health services.
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