This article synthesizes the qualitative evidence of the effectiveness of lay health workers (LHWs) as well as the factors affecting implementation of LHW programs for maternal and child health. 53 studies were included primarily describing the experiences of LHWs, program recipients, and other health workers. Results from the review suggest that rather than being seen as a lesser trained health worker, LHWs may represent a different and sometimes preferred type of health worker. The close relationship between LHWs and recipients is a program strength.
This paper explores the factors that shaped the acceptability and adoption of community health assistants (CHAs) into the health system at the district level in Zambia. Using thematic analysis, data was collected through a review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team. Results found a perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities.
Research has demonstrated that task shifting, including the use of CHWs to deliver care, can improve population health. This systematic review examines whether task shifting in LMICs results in efficiency improvements by achieving cost savings. The authors identified 794 articles, and included 34 in the study. They found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS.
This systematic review examines the effectiveness of interventions aimed at increasing access to health services for children aged 5 years and below in LMIC. Fifty-seven studies were included in the review, and approximately half of studies (49%) were conducted in sub-Saharan Africa. The studies evaluated a diverse range of interventions and various outcomes. Supply side interventions included: delivery of services at or closer to home (by CHWs, nurses, or school programs) and service level improvements (e.g. integration of services).
The purpose of this policy brief is to inform discussions and decisions in the World Health Organization (WHO) African Region on policies, strategies and programmes to increase access to primary health care (PHC) services and make progress towards universal health coverage (UHC) by expanding the implementation of scaled-up CHW programmes.
This study sought to understand CHW perspectives on a new primary health initiative in South Africa called Re-engineering Primary Health Care (rPHC). This initiative aims to provide a preventive and health-promoting community-based PHC model. Focus group discussions and surveys on the knowledge and attitudes of 91 CHWs working on community-based rPHC teams in the King Sabata Dalindyebo (KSD) sub-district of Eastern Cape Province were conducted.
This study in Tigray, Ethiopia investigated the impact of a service delivery model that combined community-based distribution (CBD) of contraception with social marketing. 626 volunteer CHWs were recruited and trained to administer depot medroxyprogesterone acetate (DMPA) injections, provide counseling and referrals, and promote demand for family planning through door-to-door outreach and community meetings. Surveys of women of reproductive age, as well as of participating CHWs, were conducted at baseline and the end of the study.
SPRING works to strengthen human resources for nutrition with the ultimate goal of increasing the number of formally-trained professional and frontline workers in nutrition, as prioritized by USAID’s Multi-Sectoral Nutrition Strategy 2014-15. This collection of resources includes the latest news, activities, publications, media, and events on strengthening human resources for nutrition.
This review explores the current evidence available to assess if increased levels of integration of community health resources in CHW programs leads to higher program effectiveness and sustainability. 32 articles were chosen for an extensive review, complemented by analysis of the results of 15 other review studies. Analysis found no quantitative data and minimal inclusion of even basic community level indicators.
Amref Health Africa in Kenya has developed a replicable Community Health Units (CHUs) Functionality Scorecard for measuring and managing the functionality of CHUs. The scorecard was designed and piloted at 114 CHUs in Rift Valley province in Kenya. The scorecard categorized CHUs as Functional, Semi-functional, or Non-Functional. Before and after data was used to assess the functionality. From January 2012 to September 2013, the proportion of functional CHU increased from 3.5% to 82.9%, Semi-Functional reduced from 39% to 13% while Non-Functional reduced from 58% to 4%.