This study examines the feasibility of incorporating treatment of severe acute malnutrition (SAM) into an existing community care framework operated by community health workers (CHWs). The study shows that delivering treatment of SAM through CHWs is cost-effective, assuming good coverage.
Tremendous challenges remain to ensure that the most vulnerable populations, including women, children, and adolescents, are able to enjoy the healthy lives and well-being promised in the Sustainable Development Goals. Much of their poor health is caused by poverty, gender, lack of education, and social marginalization as well as inaccessible healthcare services. Strong, equitable, and well-governed health systems can contribute to sustainably improving their lives.
This newly released report, titled ‘Practitioner Expertise to Optimise Community Health Systems: Harnessing Operational Insight’ examines how CHWs can successfully be integrated into national health systems, subsequently contributing towards efforts to achieve Universal Health Coverage.
In this PIH interview, Dan Palazuelos continues his vibrant roundtable series. He sat down with Ash Rogers, Executive Director of the Lwala Community Alliance in Kenya. Lwala is known for its excellence in service delivery, and perhaps more importantly, its practice of listening to and elevating the voice of the community.
Health Surveillance Assistants (HSAs) have been providing integrated community case management (iCCM) for sick children in Malawi since 2008. HSAs report monthly iCCM program data but, at the time of this study, little of it was being used for service improvement. Additionally, HSAs and facility health workers did not have the tools to compile and visualize the data they collected to make evidence-based program decisions.
This brief is an outline of Zambia’s community health assistant (CHA) program detailing the impact of a nationwide salaried cadre of CHWs. The report includes how CHAs are recruited, trained, and deployed in rural areas of Zambia. The impact of CHA programs was found to include: task shifting and uptake of services, evidence-based strategies to recruit high performance CHAs and increased the volume of health services in rural areas by expanding basic access to health services.
In 2012, a new cadre of Community Health Assistants (CHAs) were deployed as part of Zambia’s National Community Health Strategy. This study aims to evaluate the impact CHAs have on the volume and type of health services provided. Results show that the addition of CHAs in rural areas increased health service provision shifting the burden of basic health services away from more highly trained health workers. This allows policymakers to improve access to care with constrained budgets.
To improve healthcare access in rural areas, in 2010 the Government of Zambia implemented a national CHW strategy that introduced a new cadre of healthcare workers called community health assistants (CHAs). After 1 year of training the pilot class of 307 CHAs were deployed in September 2012. This paper presents findings from a process evaluation of the barriers and facilitators of implementation of the CHA pilot, along with how evidence was used to guide ongoing implementation and scale-up decisions.