Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Prevalence, incidence and predictors of volunteer community health worker attrition in Kwale County, Kenya

Retaining CHWs is essential in the sustainability of CHW programs; yet, there is little literature on reasons for their attrition that might help CHW retention. This study measured CHW attrition and its predictors in a rural area in Kenya.

How States Can Use Medicaid Managed Care Contracts to Support Community Health Workers

Sustainable funding is a significant barrier to expanding CHW work and to CHW integration into the healthcare system. This brief examines how states can use Medicaid managed care contracts to support community health workers. 

Integrating Community Health Workers Into Medical Homes

Why don’t more patient-centered medical homes (PCMHs) employ CHWs despite the evidence that they make a difference? This qualitative study researched facilitators and barriers to integrating CHWs in PCMHs in Minnesota and defines the roles of CHWs on these care teams. The study found four factors that influenced use of CHW models :1) leaders who championed the CHW model, 2) a clinic culture that was open to innovation; 3) clinic prioritization of patients’ nonmedical needs, and 4) leadership perceptions of sustainability. 

Quality of care for treatment of uncomplicated severe acute malnutrition delivered by community health workers in a rural area of Mali

This article presents findings from a study of treatment of uncomplicated severe acute malnutrition by community health workers in rural Mali. Key findings indicate that well-trained and supervised CHWs are capable of managing cases of uncomplicated SAM, there is an opportunity to increase access to quality treatment in Mali for SAM, and that resources needed to ensure continuous service should be further explored. 

Community Health Workers

This report details the history and current state of CHW programs around the world and highlights the importance of sustainability and improving CHW performance. 

Evaluation of malaria rapid diagnostic test (RDT) use by community health workers: a longitudinal study in western Kenya

This study assessed whether or not community health workers maintain competency in malaria rapid diagnostic tests (RDTs) administration over a twelve-month period as well as  the CHW characteristics, such as age or level of experience, that influence competencies. The results indicate that a majority of CHWs maintain RDT competency over at least a twelve-month period and that younger age and prior experience with RDT are associated with better RDT performance. 

The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe

This study examines Community Health Workers’ perceptions of how the Zimbabwe study for Enhancing Testing and Improving Treatment of HIV in Children (ZENITH) randomized controlled trial’s structure and management affected their performance. The results of the study showed that CHWs saw the intervention as acceptable, feasible, and expressed overall strong job satisfaction. Long term sustainability of the programme is highlighted as an issue and the future improvement and adoption of the approach in other settings are discussed.

Unit cost analysis of training and deploying paid community health workers in three rural districts of Tanzania

This paper estimates the cost of training and deploying paid community health workers in Tanzania. The authors found the estimated cost to be sustainable on a large scale. 

Practitioner Expertise to Optimise Community Health Systems: Harnessing Operational Insight

This newly released report, titled ‘Practitioner Expertise to Optimise Community Health Systems: Harnessing Operational Insight’ examines how CHWs can successfully be integrated into national health systems, subsequently contributing towards efforts to achieve Universal Health Coverage.

Stakeholder’s perspective: Sustainability of a community health worker program in Afghanistan

The objectives of this study were to examine how different stakeholders define sustainability and to identify barriers to and facilitators of the sustainability of the Afghan CHW program. 63 key informants were interviewed, and 11 focus groups were conducted with policymakers, health managers, community health workers, and community members. The interviews and focus groups showed that stakeholders define sustainability differently.

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