To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care.
Mozambique has witnessed a climbing total fertility rate in the last 20 years. Nearly one-third of married women have an unmet need for family planning, but the supply of family planning services is not meeting the demand.
The integration of community health workers (CHWs) into primary and secondary prevention functions in health programs and services delivery in Mexico and South Africa has been demonstrated to be effective. This paper aims to identify barriers and challenges to these types of CHW programs by comparing the experiences of earlier studies with successful programs. Barriers reviewed include scale up issues, training and certification issues, integration issues, and funding gaps. The authors use this information to make policy recommendations about task-sharing CHW programs.
In 2013, the Zambian Ministry of Health distributed over two million insecticide-treated bed nets (ITNs) using a door-to-door distribution strategy, and distributed more than six million ITNs in 2014. This research study measures attendance rates at community point distribution and examines the impact of follow-up community health worker visits on ITN retention and usage. This data has potential to inform ITN distribution strategies in Zambia.
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.
In the past 36 months, Nigeria has suffered several healthcare workers’ strikes, resulting in decreased access to quality healthcare for Nigerians. The researchers in this study aimed to identify the root cause(s) for these strikes and determine potential solutions. 150 Nigerian healthcare workers participated in a cross-sectional survey and questionnaire to reveal reasons for the strikes. Findings concluded that increased salaries and wages were among the most common reasons for strikes, though other issues were discussed as well.
Due to deficiencies in low- and middle-income countries, policy makers are suggesting different methods to achieving universal health coverage. One strategy is the expansion of cadres of close-to-community providers, which plays an important role for connecting communities with the formal health sector. This poster from the Reachout Consortium identifies some of the challenges with this strategy and how to address quality-related issues for universal health coverage.
At the 21st International AIDS Conference in Durban, South Africa in July 2016, Dr. Katie Simon presented findings from a study highlighting how community health workers can be utilized to address tuberculosis case detection, which often infects people living with HIV. This study found that intensified tuberculosis case finding (TB ICF) by CHWs was associated with a 20-fold increase in TB case detection at an antiretroviral therapy clinic in Malawi.
Community Health Volunteers (CHVs) have played a critical role in the success of USAID in Madagascar’s health sector. As CHVs, they can provide basic health care services and health education at the community level, thus improving health care access in remote regions. This report highlights the successes and challenges of USAID/Madagascar’s investment in CHVs.
In light of the health worker shortage due to the post-conflict period and Ebola crisis in Sierra Leone, it is crucially important to understand different motivation factors for rural health workers, including doctors, nurses, midwives and Community Health Workers. Researchers conducted 23 participatory life histories with health workers, revealing that the context of the rural healthcare setting makes it difficult for health workers to conduct their work. These findings could be used to influence policy and help build a more robust rural healthcare workforce.