Contributions in International Seminars 1988 -2008
Intercultural Pastoral Care and Counselling, no. 20
Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information
on aid investment for reproductive health in these countries is essential for improvin...g the efficiency and effectiveness of
aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in
conflict-affected countries from 2003 to 2006.
Methods and Findings: The Creditor Reporting Syst
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. Howe...ver, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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“towards quality health and social welfare services”