Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses th...ree key functions: management (ensuring performance), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if ...dbox">community-based NCD management is to be successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further assessment
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CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at home immediately after discharge from health care c...enters. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
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South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communit...an>ies and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning.
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Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal h...ealth coverage? As the proactive arm of the health services, community health workers teams provide household and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult t...o build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs) to improve adherence to medication for epilepsy i...n South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
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Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver ...integrated preventive and curative package of care of services to manage common childhood illness in hard-to-reach communities in Bondo Subcounty, Kenya
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This report presents the key findings of the end-of-project assessment of households and
community health volunteers, conducted in 2017 in the Kamukunji and Embakasi sub-counties
of Nairobi, Kenya, for a ...>Community Health Volunteers’ Decision Support System (CHV DSS)
intervention project. The report was prepared by the African Population and Health Research
Center (APHRC). The end-line survey was implemented by APHRC. Implementation of the CHV
DSS project is a joint collaboration among several partners, including APHRC, the City County
of Nairobi, sub-county health management teams (Kamukunji and Embakasi), and community
health volunteers. The opinions expressed in this report are those of the authors and do not
necessarily reflect the views of the donor organization, the County Innovation Challenge Fund
for Kenya.
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This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, used on its own, is not enough to understand the complexities of sanitation, hygiene, water, and health. ...It explores pastoralists’ views and perspectives on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.
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The Arid and Semi-Arid lands (ASAL) constitute about 80% (467,200 sq. km) of Kenya’s total land mass and is grouped into geographical zones including the Savannah covering most of the North- eastern and South-eastern parts, the Coastal region, the North Rift Valley, the Highlands and the Lake Vict...oria Basin. The ASAL host about 35% of Kenyas population (13 million people) and over 60% of its inhabitants live below the poverty line, subsisting on less than one US dollar per day.
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The mhGAP community toolkit: field test version is an integral part of WHO's Mental Health Gap Action Programme (mhGAP), and aims at scaling up services for people with mental health conditions to achieve universal health coverage.
The toolkit p...rovides guidance for programme managers on how to identify local mental health needs and tailor community services to match these needs. It offers practical information and necessary tools for community providers to promote mental health, prevent mental health conditions and expand access to mental health services.
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We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regard...ed as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based
studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative
study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD:
1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore,
we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).
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Cutaneous leishmaniasis (CL) is a parasitic disease caused by infection with a vector-borne protozoan parasite of the genus Leishmania spp. The parasite is transmitted by the bite of an infected phlebotomine sand fly. Infection results in skin lesions which take a long time to heal and may leave per...manent, disfiguring scars (de Vries et al. 2015). CL is classified as a neglected tropical disease (NTD), and in common with several other NTDs, is associated with psychosocial effects including stigma, social exclusion, and declining mental health (Bailey et al. 2019; Bennis et al. 2018; Wenning et al. 2022). Emerging evidence suggests that people with CL are at a higher risk of experiencing anxiety, depression, decreased body satisfaction, loss of social status, and lower quality of life (Bennis et al. 2018; Yanik et al. 2004). The global mean age-standardised disability-adjusted life years (DALYs) lost by CL was 0.58 per 100,000 people (Karimkhani et al. 2016). Notably, this statistic only considers the physical effects of the lesions and does not account for the potentially considerable psychological and social effects of CL (Bailey et al. 2017; Bailey et al. 2019; Wenning et al. 2022).
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The PS Centre has released three publications addressing the need for MHPSS tools and guidance in Ukraine and surrounding countries.
The Introduction to Psychological First Aid, presents a training module on basic psychological first aid skills for people affected by the international armed confl...ict in Ukraine which can be delivered in four hours. It is an adaption of another PS Centre publication, Training in Psychological First Aid for Red Cross and Red Crescent Societies. Module 1. An introduction to PFA.
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The* Facilitator manual on community-based psychosocial support *and the* Volunteers manual on community-based psychosocial support* provides resources for trainers and participants in key aspects o...f psychosocial support, including understanding the impact of crisis events, supportive communication, protection issues and self-care.
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Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and m...obile apps. The ‘Introduction to Information and Communication Technology and eHealth’ course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.
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Interpeace has been working with the government and non-governmental actors in Rwanda for over 20 years, focusing on societal healing and participatory governance. Currently, Interpeace is implementing a holistic peacebuilding programme titled ‘Reinforcing ...x">community capacity for social cohesion and reconciliation through societal trauma healing in Rwanda’. This programme has four pillars: mental health and support; social cohesion and reconciliation; collaborative livelihoods; and prisoner rehabilitation and reintegration.
Interpeace and its partners have collaborated with national and international experts to design structured psycho-social interventions, scientifically known as ‘protocols’, which aim to support healing and peace processes. These protocols include resilience-oriented therapy, adaptations of sociotherapy, multifamily therapy, the collaborative livelihoods (COLIVE) protocol, the prisoner rehabilitation and reintegration curriculum, and the socio-emotional skills curriculum.
These protocols guide interventions in healing spaces for Genocide survivors, Genocide perpetrators, former combatants, and their descendants. They facilitate mutual healing and reconciliation, strengthen the mental resilience of individuals and communities, promote family cohesion, and address the intergenerational transmission of Genocide legacies. They also underpin initiatives to develop collaborative livelihoods and skills development, and the psychological rehabilitation and reintegration of prisoners, particularly those convicted of Genocide crimes.
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WHO/Europe has launched a new guide, providing support to countries on how to apply behavioural and cultural insights (BCI) for health. It presents a simple step-wise approach, complemented by a rich collection of detailed considerations, tools and exercises. The guide is the first of its kind, spec...ifically developed for use by public health professionals developing policies, services and communications informed by BCI across health topics.
Some of the most persistent public health challenges involve human behaviour. Using a BCI lens means that health policies, services and communications can be tailored to the needs and circumstances of people and communities, and thereby help combat these challenges. The new Tailoring Health Programmes (THP) guide describes how this can be done.
Building on several topic-specific guides that focused on applying BCI to routine and influenza vaccination and tackling antimicrobial resistance, as well as external evaluations and a rigorous peer-review process, this guide is the result of over a decade of work by WHO/Europe. The THP approach has already been adopted in over 20 countries and has received positive feedback from public health agencies.
“This guide is the culmination of a decade of work involving many colleagues at country, regional and global levels. The guide is our “BCI bible”, guiding our work with and in countries to help tackle persistent health challenges,” said Katrine Bach Habersaat, Regional Advisor for BCI at WHO/Europe.
Karina Godoy, Senior Analyst and National Focal Point for Behavioural Insights at the Public Health Agency of Sweden, who is employing the approach described in the guide across several health projects, comments: “The THP guide is easy to use and at the same time provides detailed guidance and inspiration where needed. We have decided to translate the document into Swedish and use the approach widely”.
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