Most countries in sub-Saharan Africa have now adopted integrated community case management (iCCM) of common childhood illnesses as a strategy to improve child health. In March 2014, the iCCM Task Force published an Indicator Guide for Monitoring and Evaluating iCCM: a ‘menu’ of recommended indicators with globally agreed definitions and methodology, to guide countries in developing robust iCCM monitoring systems. The Indicator Guide was conceived as an evolving document that would incorporate collective experience and learning as iCCM programmes them- selves evolve.
In 2004, the Government of Ethiopia introduced the Health Extension Programme (HEP), a free primary health care package with four components: disease prevention and control, family health, hygiene and environmental sanitation, and health education and communication. A female cadre of salaried community health workers (CHWs) called health extension workers (HEWs) was introduced nationally. HEWs are linked to the community through a network of community volunteers, who are members of the health development army (HDA).
Community health workers (CHWs) have been proposed as a means for bridging gaps in healthcare delivery in rural communities. Recent CHW programmes have been shown to improve child and neonatal health outcomes, and it is increasingly being suggested that paid CHWs become an integral part of health systems. Remuneration of CHWs can potentially effect their motivation and focus. Broadly, programmes follow a social, monetary or mixed market approach to remuneration.
Volunteer community health workers (VCHW) are health care providers who are trained but do not have any professional certification. They are intended to fill the gap for unmet curative, preventative, and health promotion health needs of communities.
Countries seeking to expand health services to the community-level to ensure equity of access to care frequently turn to community health workers (CHW) as an essential expansion of the health team. A variety of approaches to training, hiring and supporting community health workers have been implemented by countries, and there are many important lessons learned to be shared across countries.
A systematic review of published research was conducted in order to understand factors that may influence the integration of national community-based health worker (CBHW) programs into low- and middle –income countries. Four programs – Brazil, Ethiopia, India, and Pakistan – met the inclusion criteria and were integrated into their specific health systems. Several factors were included that facilitated the integration process, as well as other factors that inhibited the integration process.
This report outlines a series of workshops convened by mPowering Frontline Health Workers and partners to consider whether the global health community is following the most beneficial route to provide relevant and effective health training for FLHWs.
Close-to-community (CTC) providers, including community health workers or volunteers or health extension workers, can be effective in promoting access to and utilization of health services. Tasks are often shifted to these providers with limited resources and support from CTC programmes or communities. The Community Health System Strengthening (CHSS) model is part of an improvement approach which draws on existing formal and informal networks within a community, such as agricultural or women’s groups, to support CTC providers and address gaps in community-based health services.
Many global health practitioners are currently reaffirming the importance of recruiting and retaining effective community health workers (CHWs) in order to achieve major public health goals. This raises policy-relevant questions about why people become and remain CHWs. This paper addresses these questions, drawing on ethnographic work in Addis Ababa, the capital of Ethiopia, between 2006 and 2009, and in Chimoio, a provincial town in central Mozambique, between 2003 and 2010.
This formative research report by the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) examines both supply-side and demand-side dimensions of maternal and newborn health care. A key aim of the research was to understand the low rates of interaction between mothers and trained frontline health workers, including health extension workers, volunteer community health workers, and traditional birth attendants. The formative research has clear implications for training, collaborative quality improvement, and behavioral change communication strategies of the MaNHEP program.