In order to confirm the effectiveness of community health workers’ involvement as counselors or case managers in a self-help diabetes management program among Korean Americans in the Baltimore-Washington metropolitan area, a randomized controlled trial was utilized. Different groups were counselled by either a CHW or an RN, with the CHW’s performance being comparable to the RN for psychobehavioral and physiological outcomes.
With the introduction of the Patient Protection and Affordable Care Act’s (PPACA), a unique opportunity to integrate community health worker models into health care delivery exists. This article discusses several different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration.
Using a life history approach, 26 Northern Ugandan health workers with experience working in the public and private not-for-profit (PNFP) sectors were interviewed to reveal their experiences both during and after the Northern Uganda conflict and to better understand what influenced these health workers to move between these two sectors. Most workers moved from the PNFP to the public sector, as during the conflict PNFP was more stable and offered better quality training. After the conflict, the public sector was rebuilt and offered more for health care workers.
Using mobile job aids can help CHWs deliver integrated counseling on family planning and HIV/STI screening by following a step-by-step service delivery algorithm. Lessons learned during the pilot led to the development of additional features during scale-up to exploit the other major advantages that mHealth offers including:
· Better supervision of health workers and accountability for their performance
· Improved communication between supervisors and workers
· Access to real-time data and reports to support quality improvement
Deployment of resident female Community Health Extension Workers (CHEWs) to a remote rural community led to major and sustained increases in service utilization, including antenatal care and facility-based deliveries.
Key components for success include:
1) providing an additional rural residence allowance to help recruit and retain CHEWs;
2) posting the female CHEWs in pairs to avoid isolation and provide mutual support;
3) ensuring supplies and transportation means for home visits; and
4) allowing CHEWs to perform deliveries.
The Ebola pandemic of 2014-16 demonstrated the crucial role of the community health workforce in preventing, responding to, and effectively treating health emergencies. As the West Africa region rebuilds its health systems after Ebola, countries and communities have identified a need to develop strategies and plans to embed the role of the community health workers (CHWs) as a foundation of an effective healthcare system. The aim of this report is to outline conclusions from the Wilton Park meeting on the topic.