The focus of this report is on the financial sustainability of Community Health Worker (CHW) programs in the state of Connecticut. The goal of this research is to find a way in which Connecticut can develop an effective program that utilizes CHWs to improve patient health outcomes and achieve a level of positive financial return. This report worked within the boundaries of Connecticut’s State Innovation Model (SIM), a federally funded grant to aid in transforming healthcare systems from state to state, in order to ensure a possible funding source for the resulting new programs. The repor
The objective of this paper was to assess if training Health Surveillance Assistants (HSAs) in couples counseling would increase modern family planning uptake among young women in Malawi. In this cluster randomized controlled trial, 30 HSAs from Lilongwe, Malawi received training in family planning. The HSAs were then randomized 1:1 to receive or not receive additional training in couples counseling. All HSAs were asked to provide family planning counseling to women in their communities and record their contraceptive uptake over 6 months.
This paper explores the motivation to become a community health assistant (CHA) in Zambia, the experiences of working in a rural district, and how these experiences affected CHAs’ motivation to work. To examine CHAs’ experiences, data was collected through in-depth interviews with 12 CHAs and observations were analyzed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs.
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 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 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.
In Kenya, maternal and child mortality rates are still high despite government efforts aimed at improving MCH. This study’s objective was to determine the effect of a CHW led primary health care intervention, Community Health Strategy (CHS) on focused antenatal care (FANC) in Mwingi, Kenya. Researchers employed a pretest -posttest experimental study design with 1 pretest and 2 post-test surveys in intervention and control sites. Data was collected from 422 households in each survey and the main respondents were women with a child aged 9-12 months.
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.