Video Spotlight

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

Strengthening the role of Community Health Representatives in the Navajo Nation

The objective of this study was to evaluate how the Community Outreach and Patient Empowerment (CORE) program has affected Navajo Nation Community Health Representative (CHR) teams over the past 6 years. COPE staff members surveyed CHRs in 2014 and 2015 about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams.

Hope and despair: community health assistants' experiences of working in a rural district in Zambia.

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.

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.

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%.

Effect of Community Health Strategy on Focused Antenatal Care Coverage: A Pretest-Posttest Experimental Study in Rural Mwingi West Sub-County; Kenya

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.

Stakeholder’s perspective: Sustainability of a community health worker program in Afghanistan

The objectives of this study were to examine how different stakeholders define sustainability and to identify barriers to and facilitators of the sustainability of the Afghan CHW program. 63 key informants were interviewed, and 11 focus groups were conducted with policymakers, health managers, community health workers, and community members. The interviews and focus groups showed that stakeholders define sustainability differently.

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. 

Community Health Committees (CHCs) and Health Facility Management Committees (HFMCs) Program Functionality Assessment

This document provides tools for assessing the functionality of two types of representative health groups: the Community Health Committee (CHC) and the Health Facility Management Committee (HFMC). Tools are available to assess program functionality through documents such as a roles and responsibilities checklist, assessment and improvement matrices, a validation questionnaire, and an action plan template. Specific resources are available to assess the support provided to CHW Programs including recruitment, training, supervision, and incentives. 

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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