Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Community Health Worker’s Role in Bridging the Gap to Universal Healthcare in Rural Kenya

Kenya does not have a strong health infrastructure to support its people causing concern with current universal healthcare goals.  Kenya worries it will not be able to deliver care without a strong CHW program such as Rwanda’s.  Although Kenya already has CHWs working in certain areas, they are overwhelmed with large numbers of families per CHW and are not able to provide adequate care to everyone.  This article cites Rwanda’s success with a larger CHW program and results of significantly better health, pushing for Kenya to do the same.

 

Case Studies of Large-Scale Community Health Worker Programs

This resource from USAID and MCHIP provides an overview of large-scale CHW programs from 13 countries: Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia, Iran, Nepal, Niger, Pakistan, Rwanda, Zambia and Zimbabwe. Case studies address the historical context of CHWs, the health needs of the country, the scope of work of the CHWs, CHW training, support and supervision, and financing of CHW programs. The demonstrated impact and continuing challenges of the different programs are also addressed.

Balancing workload, motivation and job satisfaction in Rwanda: assessing the effect of adding family planning service provision to community health worker duties

While task shifting to CHWs is widely practiced to address healthcare provider shortages, it can add to an already heavy workload for CHWs. In order to reflect how CHWs perceive and react to their circumstances, this study combined perception and objective measures of workload to examine quality of services, worker performance, and job and client satisfaction. 

Acting on the Call June 2016 Report

USAID's 2016 Acting on the Call Report provides updates from the program that aims to end preventable maternal and child deaths in 25 priority countries, which together accounted for more than two-thirds of child and maternal deaths worldwide.

Rwanda’s evolving community health worker system: a qualitative assessment of client and provider perspectives

Community health workers (CHWs) can play important roles in primary health care delivery, particularly in settings of health workforce shortages. However, little is known about CHWs’ perceptions of barriers and motivations, as well as those of the beneficiaries of CHWs. In Rwanda, which faces a significant gap in human resources for health, the Ministry of Health expanded its community health programme beginning in 2007, eventually placing 4 trained CHWs in every village in the country by 2009.

Experiences engaging community health workers to provide maternal and newborn health services: Implementation of four programs

A paucity of skilled health providers is a considerable impediment to reducing maternal, infant, and under-five mortality for many low-resource countries. Although evidence supports the effectiveness of community health workers (CHWs) in delivering primary healthcare services, shifting tasks to this cadre from providers with advanced training has been pursued with overall caution—both because of difficulties determining an appropriate package of CHW services and to avoid overburdening the cadre.

Improved Retention Associated With Community-Based Accompaniment for Antiretroviral Therapy Delivery in Rural Rwanda

Minimizing death and ensuring high retention and good adherence remain ongoing challenges for human immunodeficiency virus (HIV) treatment programs. We examined whether the addition of community-based accompaniment (characterized by daily home visits from a community health worker, directly observed treatment, nutritional support, transportation stipends, and other support as needed) to the Rwanda national model for antiretroviral therapy (ART) delivery would improve retention in care, viral load suppression, and change in CD4 count, relative to the national model alone. (2013)

Community-based accompaniment and psychosocial health outcomes in HIV-infected adults in Rwanda: a prospective study

We examined whether the addition of community-based accompaniment to Rwanda's national model for antiretroviral treatment (ART) was associated with greater improvements in patients' psychosocial health outcomes during the first year of therapy. We enrolled 610 HIV-infected adults with CD4 cell counts under 350 cells/μL initiating ART in one of two programs. Both programs provided ART and required patients to identify a treatment buddy per national protocols.

Factors Affecting Availability of Essential Medicines among Community Health Workers in Ethiopia, Malawi, and Rwanda: Solving the Last Mile Puzzle

To understand how supply chain factors affect product availability at the community level, the Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood Project developed a theory of change (TOC) framework for gathering, organizing, and interpreting evidence about supply constraints to community case management (CCM). Baseline assessments in Ethiopia, Malawi, and Rwanda conducted in 2010 provided information on the strengths and weaknesses of existing CCM supply chains.

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