Pathfinder International Ethiopia has extensive experience implementing family planning (FP)/HIV integration through public health centers (HCs) and community networks. This brief describes Pathfinder's approach and its evolution and scale-up over time. It presents their experience in relation to the recommendations of World Health Organization (WHO) guidelines on FP/HIV integration and also outlines next steps and recommendations
Humanitarian crises are often marked by large-scale, externally funded, and vertically managed responses. National health systems, already weak, are often bypassed by international organizations in the interest of rapid response to save lives. There is growing recognition, however, of the importance of employing more sustainable approaches through existing health system infrastructure to ensure services continue as the emergency subsides and organizations and their resource flows end.
This presentation at a Malaria Consortium symposium on improving the diagnosis of pneumonia in children during the 63rd annual American Society of Tropical Medicine and Hygiene on 3-6 November 2014, presents Malaria Consortium's pneunomia diagnostics project and the preliminary findings from the evaluation stage of the project. The presentation includes key considerations and best practice methodologies on the accuracy and acceptability of pneumonia diagnostic tools for community health workers in low and middle income countries.
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.