This article from the Bulletin of the WHO, describes various roles played by Accredited Social Health Activists (ASHAs), India's national cadre of village-based workers, and other innovative community health programs working on maternal and child health, sanitation and hygiene, contraception, immunization and other health issues. CHWs are making major contributions to national efforts to reduce health inequalities and address social conditions that threaten the population’s health and access to care.
This paper is one of a series of background papers commissioned by WHO for the October, 2011, World Conference on Social Determinants of Health. It describes Rwanda's attempt to improve maternal indicators by pairing a community performance-based financing (CPBF) strategy to empower CHWs with a strategy to incentivize mothers. The pilot intervention was conducted in 31 of Rwanda's poorest health centers; three maternal and child indicators were monitored. Results from the pilot showed significant increases in the number of women accessing antenatal care and delivering at health centers.
This is the second (2005) edition of the Community Health Worker Training Manual of Afghanistan’s Ministry of Public Health. The training manual provides an overview of the roles and responsibilities of CHWs in meeting the health needs of the population, as well as key information and skills the CHWs require. Each chapter includes sections on: background, things to know, things to do and key points.
This is a tool created by the U.S. Office of Rural Health Policy (ORHP) (a program of the Health Resources and Services Administration) to support the development of CHW programming in rural areas in the U.S.. It draws on and shares lessons learned from proven CHW program models. The toolkit has eight modules: Introduction to CHWs; CHW Program Models; Training Approaches for CHWs; Implementation of CHW Programs; Planning for Sustainability; Measuring and Evaluating the Impact of CHW Programs; Dissemination of CHW Resources and Promising Practices; and, a Rural CHW Program Clearinghouse.
This study documents the perceptions of CHWs on their knowledge and communication needs, image building through mass media and mechanisms for continued education. Focus group discussions were held with health workers and their supervisors in all four provinces in Pakistan. About four fifths of the respondents described their communication skills as moderately sufficient and wanted improvement. Knowledge on emerging health issues was insufficient and the respondents showed willingness to participate in their continued education.
The authors conducted a systematic review of studies conducted between 1987 and 2007 in sub-Saharan Africa on the impact of CHW programs on morbidity and mortality of children under six. Seven studies in which CHWs provided curative treatment were included in the review. The authors conclude that CHW programs have the potential to contribute to large gains in child survival. However, the available evidence is severely limited and therefore large-scale and rigorous studies are urgently needed.
This document provides guidance and resources for implementing policy recommendations to integrate CHWs into community-based efforts to prevent chronic disease. After providing general information on CHWs in the United States, it sets forth evidence demonstrating the value and impact of CHWs in preventing and managing a variety of chronic diseases, including heart disease and stroke, diabetes, and cancer.
This toolkit, designed by the Rural Assistance Center (RAC), provides help in developing CHW programs and resources and best practices developed by successful CHW program. It is made up of 8 modules, each focusing on different aspects of CHW program, including: introduction to CHW, program models, training approaches, program implementation, planning for sustainability, measuring program impacts, disseminating best practices and a program clearinghouse.
The Arizona Prevention Research Center's (University of Arizona) Diabetes and the Family Curriculum is a tool for CHWs, focusing on health promotion and chronic disease prevention designed for individuals and their families. The tool is available in both English and Spanish.
This article describes a qualitative study that examines the efficacy of non-financial incentives in sustaining volunteerism among CHWs. The study addresses: the motivation of volunteer CHWs; barriers and de-motivating factors; the effectiveness of non-financial incentives; and the mechanisms by which incentives motivate volunteer CHWs. The study also explores the role of community anchors or local institutions in sustaining volunteerism among CHWs.