National CHW schemes are an increasingly important tool for achieving universal health coverage and ending maternal and child deaths by 2030. This article focuses on critical issues that face the effectiveness of large-scale CHW programs drawing on the experiences of India’s CHW scheme –the Village Health Guides.
To support quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix tool. This tool can be applied at district, regional, and national levels to identify and close gaps in design and implementation and, ultimately, enhance program performance.
How will we address the predicted worldwide shortage of over 14 million health workers by 2030? At the World Economic Forum in Davos Switzerland in 2015, a 4-year US$100 million fund supporting Last Mile Health and Living Goods to train 50,000 CHWs in six countries was launched. This commentary details the goals and challenges of such an initiative.
The planned roll out of the Community Health Extension Worker (CHEW) program in Uganda is set to be implemented in 2018. Based on the Ugandan Ministry of Health’s extensive experience with Village Health Teams in the past decade, this commentary addresses potential challenges that will arise in the implementation of the new CHEW program.
This analysis covers a 7-year interrupted time series that investigated early access to care and under-five morality during a proactive community case management intervention in periurban Mali. Prevalence of febrile illness in children under 5 years went from 39.7% to 22.6% in 7 years. Early antimalarial treatment more than doubled for young children under 5. Under-five mortality lowered to 7/1000 in 2015.
This cross case analysis of leadership and governance roles involved in implementing large-scale community health worker programs at sub-national level. The authors identified four key roles for leaders and governments in implementing these programs.
This cluster randomised controlled trial looked at the ability to train CHWs in Malawi to identify individuals with ear and hearing disorders. The intervention and training were effective and could be scaled up to CHWs in other countries.
This paper investigates the effect of expanding the population coverage of evidence-based interventions that community health workers provide outside of facilities. Using the Lives Saved Tool, the authors examined 73 countries and estimated that, if population coverage was expanded to 90%, 6.9 million lives of mothers and their children under the age of 5 could be saved during the period from 2016 to 2020.