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.
This brief explains how community health workers improve people’s health, reduce health care costs, and address barriers to care. The brief continues to discuss key questions regarding sustainable funding of CHW programs through Medicaid reimbursement for states that want to start or expand such programs. Case studies in Massachusetts, Minnesota, and New Mexico are presented, detailing how these states fund, train, certify, and integrate CHW programs. Finally, the authors discuss what state advocates need to know to move forward with building or expanding CHW programs in their state.
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.
Recent years have proven that community health workers serve important roles in healthcare systems, including in the United States. This article briefly discusses the effectiveness and versatility of community health workers and their various roles in healthcare delivery systems. The evidence demonstrates the effectiveness of community health workers in many diverse public health-related roles.
As community health workers gain more and more responsibility amidst shortages of skilled health workers, mobile technology for health (mHealth) is becoming more popular for health care delivery around the globe. In order to better understand the role mHealth applications have among CHWs, researchers tested whether short message services (SMS) could improve the reporting of pregnancies and pregnancy outcomes among CHWs. Findings from a cluster-randomized intervention show that groups that received motivational SMS, with or without data quality SMS, improved documentation of pregnancies.
The Ebola virus outbreak in 2013 revealed that health delivery systems in western Africa were not well-equipped to handle such epidemics. This paper argues that robust community health worker programs should be implemented as a strategy for improving global health responses to disasters such as the Ebola outbreak. Because CHWs have built strong relationships with the communities they serve, they are able to navigate many of the cultural and societal factors that resulted in Ebola's persistence.
Using the popular mobile application WhatsApp, a mobile learning intervention was developed and designed to strengthen supervisory support for CHWs in Kenya. 6 months of conversations were analyzed and CHWs and supervisors interviewed to determine how WhatsApp was used in these settings. This preliminary data suggests that CHWs and their supervisors can be effectively trained to tailor their communication in ways that will improve supervisory support, however further research should be conducted.
CHWs importantly deliver health care services to communities when shortages in the healthcare workforce exist. However, as their workload increases, CHW abilities to provide quality healthcare may be compromised. Using a cluster-randomized trial in Zimbabwe, CHWs were surveyed to assess the association between demographic and work characteristics and task performance. CHWs who made more referrals shared many common demographic and work characteristics, implying that these factors influence performance.
Daniel Palazuelos, Partners In Health, and Dr. Kevin Fiori, co-founder of Hope Through Health, discuss Dr. Fiori’s organization and global health. Hope Through Health is an organization dedicated to health care delivery in Togo and faced many challenges in its beginnings, but now successfully utilizes community health workers to empower the community and has increased the capacity of the community to hold the health care system accountable for quality and effective health care.