Video Spotlight

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

Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries

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.

A systematic review of strategies to increase access to health services among children in low and middle income countries

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).

Community Health Worker Programmes in the WHO African Region: Evidence and Options

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. 

Community health worker perspectives on a new primary health care initiative in the Eastern Cape of South Africa

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.

Community Health Workers as Social Marketers of Injectable Contraceptives: A Case Study from Ethiopia

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.

Strengthening Human Resources for Nutrition

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. 

The Influence of Community Health Resources on Effectiveness and Sustainability of Community and Lay Health Worker Programs in Lower-Income Countries: A Systematic Review

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.

A scorecard for assessing functionality of community health unit in Kenya

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%.

Mobilizing Action on Violence Against Women—A Hand Book for ASHAs

This handbook provides information and tools to address violence against women. Included in the resource is a definition of different types of violence, signs and symptoms to be aware of, consequences of violence against women, the role of a CHW in addressing violence against women, and situations for discussion. While the handbook was made for accredited social health activists (ASHAs), it is a useful resource for any type of CHW. 

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.

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