Kenya does not have a strong health infrastructure to support its people causing concern with current universal healthcare goals. Kenya worries it will not be able to deliver care without a strong CHW program such as Rwanda’s. Although Kenya already has CHWs working in certain areas, they are overwhelmed with large numbers of families per CHW and are not able to provide adequate care to everyone. This article cites Rwanda’s success with a larger CHW program and results of significantly better health, pushing for Kenya to do the same.
This article provides background information on the incentive system for India’s Accredited Social Health Activists (ASHAs). India has created an outcome-based incentive system which creates a clear difference in payment per patient.
This article draws on the importance of CHWs in post conflict countries. Sidibe details personal experience in East Timor where he worked as a Peace Corps Volunteer, but emphasizes his new work in Liberia and the health improvements that have been made as a result of CHWs. Liberia and surrounding nations post Ebola were left with a lack of health resources posing a challenge to its people. With the support of the international community these countries are now establishing CHWs to help with preventative care in communities across the country.
In Zambia, the 2010 National Community Health Worker Strategy (NCHWS) created a cadre of salaried Community Health Assistants (CHAs) to work in rural and underserved areas providing access to health care and developing prevention measures. The Ministry of Health (MOH) is currently in the process of creating a workforce of 5,000 CHAs. After the first class of CHAs graduated, a process evaluation was conducted. This study is the second evaluation of the program, which has since grown due to results of the first evaluation. The goal of this study was to evaluate long-term needs of a large-
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 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.
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 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.
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%.