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%.
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.
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.
SPRING, in collaboration with USAID, has created a new CHW Nutrition Advocacy Tool, which consists of a series of PowerPoint slides with important data regarding key nutrition responsibilities for CHWs. Information in these slides identify current gaps in nutrition service delivery and advocates for increased commitment to nutrition in community health programs. Stakeholders can use these materials to identify which nutrition-related services CHWs can provide, prioritizes CHW responsibilities, and builds a stronger foundation of policies, tools, and systems for CHWs to conduct their work.
This paper assesses the change in the use of essential maternal and child health services in Konobo, Liberia after the implementation of an enhanced CHW program. Last Mille Health, a nongovernmental organization, partnered with the Liberian Ministry of Health to pilot the CHW program. The program had enhanced recruitment, training, supervision, and compensation. Researchers conducted cross-sectional cluster surveys before and after the program implementation.
This review article explores the various definitions and descriptions of CHWs in the literature. It also identifies common themes in these definitions to better understand the essential characteristics of health workers classified as CHWs and to distinguish them from other healthcare providers. By describing the various categories of CHWs, this resource helps to clarify the use of the term to ultimately aid key stakeholders in community health program planning, policy, and research.
In Madagascar 83% of the country’s 22.9 million people live in rural areas that can be difficult to access. CHWs play a crucial role in providing access to healthcare in those parts of the country that are underserved. Over 34,000 CHWs work to extend basic health services such as maternal and child health, family planning and reproductive health, nutrition, TB, and sanitation services. This study seeks to examine the influence both financial and non-financial incentives have on CHW program performance and retention in Madagascar.
Mozambique has one of the highest rates of maternal mortality in sub-Saharan Africa. To effectively address maternal mortality in the post-2015 agenda, interventions need to consider the determinants of health so that their delivery is not limited to the health sector. The objective of this exploratory qualitative study was to identify key community groups’ perspectives on the perceived determinants of maternal health in rural areas of southern Mozambique.
Pre-eclampsia is a leading cause of maternal and fetal morbidity and mortality worldwide. Early detection and treatment have been instrumental in reducing case fatality in high-income countries. This study was part of a multi-country evaluation of community treatment of pre-eclampsia to determine community health workers' knowledge and practice in the identification and treatment of pre-eclampsia, as they are essential providers of maternal care services in Nigeria.