This document is the report from a workshop that brought together public health and mobile technology experts. The group examined how the use of mobile phones and other related technology can improve health care delivery by supporting CHWs and integrated Community Case Management (iCCM) programs. The report presents scenarios that demonstrate how mobile technology can be used to: bridge gaps between suppliers and health providers; give voice to community demands; and, promote recognition of high-performing CHWs.
This report presents the findings and recommendations of the Global Health Workforce Alliance’s Task Force for Scaling Up and Training for Health Workers, focusing on countries with a health workforce crisis. The report uses evidence from Brazil, Ethiopia,and India on what can and has been done to expand the education and training of health workers quickly and on a national scale, by national governments as well as education and training bodies. The Task Force estimates it would require US $2.6 billion a year to educate and train 1.5 million additional health workers in Africa.
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 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 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.
The South African Academy of Family Practice's Rural Health Initiative journal details their delegation's visit and observation of the rural primary health care network in Iran. They examined in particular the roles of different workers in the Iranian system and the health houses that are staffed by CHWs, known locally as, Behvarz. The health houses are responsible for: maternal and child health, TB, Malaria, mental health, chronic illnesses, symptomatic treatment, environmental health and occupational health.
This journal article looks at a study conducted in 2007 to evaluate the impact of community directed intervention (CDI) on delivering five health interventions in onchocerciasis endemic districts in Tanzania: Vitamin A supplementation (VAS), community-directed treatment with Ivermectin (CDTi), distribution of insecticide -treated nets (ITN), directly observed treatment of TB (DOTS), and home-based management of Malaria (HMM).