This paper outlines the importance of a systems approach when task shifting to CHWs, arguing that it cannot work unless close attention is paid to both the systems that support successful implementation and to needed expansion of human resources within the overall health care system. The paper incorporates discussion on taking a systems approach; the planning and regulatory … [Read more...] about Systems support for task-shifting to community health workers
Issue papers
Community health workers as a cornerstone for integrating HIV and primary healthcare
This paper describes the contribution of the non-governmental organization Zanmi Lasante (ZL) to scaling up HIV prevention and treatment and improving primary health care services in the public health system in Haiti. ZL’s model utilizes CHWs to supervise antiretroviral therapy and provide community outreach, including active case finding and outreach to marginalized … [Read more...] about Community health workers as a cornerstone for integrating HIV and primary healthcare
The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery
This paper reviews the development of the Community-based Heath Planning and Services (CHPS) Initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Over a 2-year period, 104 out of 110 districts in Ghana started CHPS, employing strategies tested in the successful Navrongo … [Read more...] about The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery
Lessons from Community-based Distribution of Family Planning in Africa
This paper reviews several initiatives in sub-Saharan Africa to implement community-based distribution (CBD) of family planning services. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt. This report reviews reasons for the limited impact of CBD in Africa, compared with similar … [Read more...] about Lessons from Community-based Distribution of Family Planning in Africa
Community-based health workers achieve high coverage in neonatal intervention trials: a case study from Sylhet, Bangladesh
This paper describes a large-scale community-based efficacy trial of chlorhexidine for cleansing the umbilical cord conducted in rural north-eastern Bangladesh. The trial established a two-tiered system of community-based workers: paid community health workers (CHWs) and volunteer village health workers (VHWs). The community-based workers delivered a package of essential … [Read more...] about Community-based health workers achieve high coverage in neonatal intervention trials: a case study from Sylhet, Bangladesh