This brief is an outline of Zambia’s community health assistant (CHA) program detailing the impact of a nationwide salaried cadre of CHWs. The report includes how CHAs are recruited, trained, and deployed in rural areas of Zambia. The impact of CHA programs was found to include: task shifting and uptake of services, evidence-based strategies to recruit high performance CHAs and increased the volume of health services in rural areas by expanding basic access to health services.
For the organizations who have dedicated themselves to building good CHW programs, where can they go to learn how to make programs that are built to thrive? The Center for Health Market Innovation awarded two like-minded health delivery organizations, Last Mile Health in Liberia and Possible in Nepal, a learning exchange grant.
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.
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.
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.
This paper assesses the change in the use of essential maternal and child health services in Konobo, Liberia after the implementation of an enhanced CHW program. Last Mille Health, a nongovernmental organization, partnered with the Liberian Ministry of Health to pilot the CHW program. The program had enhanced recruitment, training, supervision, and compensation. Researchers conducted cross-sectional cluster surveys before and after the program implementation.
This review article explores the various definitions and descriptions of CHWs in the literature. It also identifies common themes in these definitions to better understand the essential characteristics of health workers classified as CHWs and to distinguish them from other healthcare providers. By describing the various categories of CHWs, this resource helps to clarify the use of the term to ultimately aid key stakeholders in community health program planning, policy, and research.
The emerging field of mobile health (mHealth) consists of interventions that apply cellular phones and other mobile devices for healthcare purpose such as data collection, clinical decision support, self-care, and CHW management. This rapid expansion of mobile communications systems represents an opportunity to improve the productivity of community health workers in rural areas.
In Madagascar 83% of the country’s 22.9 million people live in rural areas that can be difficult to access. CHWs play a crucial role in providing access to healthcare in those parts of the country that are underserved. Over 34,000 CHWs work to extend basic health services such as maternal and child health, family planning and reproductive health, nutrition, TB, and sanitation services. This study seeks to examine the influence both financial and non-financial incentives have on CHW program performance and retention in Madagascar.
An evaluation of trauma-informed support, skills, and psychoeducation interventions provided by CHWs on depressive symptoms, dysfunction, post-traumatic stress, traumatic grief and anxiety symptoms was conducted in the northern Dohuk region of Kurdistan Iraq. Recruited community health workers included pharmacists, nurses, and physician assistants without any prior formal mental health training.