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Community health workers at the dawn of a new era: 9. CHWs’ relationships with the health system and communities

Karen LeBan , Maryse Kok and Henry B. Perry Health Research Policy and Systems (2021) CC

This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha... more

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Ghana National Community Health Worker Training Manual. Module I: Community Health Basics

Ministry of Health, Ghana; World Vision (2013) CC

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The legal and regulatory framework for community pharmacies in the WHO European Region

World Health Organization WHO, Regional Office of Europe (2019) C_WHO

Community pharmacists are the health professionals most accessible to the public and are a cornerstone of primary health care. The role of community pharmacists is expanding globally. This report provides an overview of existing components and provisions of the legal and regulatory framework for com... more

National guidance and district-level practices in the supervision of community health workers in South Africa: a qualitative study

Assegaai, T. and H. Schneider Human Resources for Health (2019) C1

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 three key functions: management (ensuring performance... more

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The roles, training and knowledge of community health workers about diabetes and hypertension in Khayelitsha, Cape Town

Tsollekile, L.P.; H. Schneider and T. Puoane Curationis (2018) CC

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 community-based NCD management is to b... more

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Training and Evaluation of Community Health Workers (CHWs): Towards Improving Maternal and Newborn Survival in an Urban Setting in KwaZulu-Natal, South Africa

Thoko Ndaba1, Myra Taylor, Musawenkosi Mabaso The Open Public Health Journal (2019) C1

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... more

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An analysis of the services provided by community health workers within an urban district in South Africa: a key contribution towards universal access to care

Thomas, L.S., E. Buch and Y. Pillay Human Resources for Health (2021) C1

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 health coverage? As the proactive arm of the health services, community health workers teams provide ho... more

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Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya

Wandabwa, M.S. ; Kabue M., Kasungami D., et al. , (2018) C1

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 h... more

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Community Health Volunteers' Decision Support System Project

P. Bakibinga, Kamande E. , Kisia L., et al. African Population and Health Research Centre APHRC (2018) C1

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 re... more

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Societal Healing Programme in Rwanda - Programme Intervention Protocols: Reinforcing community capacity for social cohesion and reconciliation through societal trauma healing in Rwanda

Interpeace (2023) C_WHO

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 community capacity for social cohesion an... more

Community conversation kit: everyday conversations to protect community health against infectious diseases

World Health Organization WHO (2024) C_WHO

This Community Conversation Kit (CCK) is designed to help people who have a leadership role speak with people in their community about how to protect themselves and those they care about from becoming ill with an infectious disease. This kit will help lead conversations that get people talking with ... more

A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno Distr

Wroe, E.B.; Nhlema, B.; Dunbar, E.L. et al. BMJ Global Health (2021) CC

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan... more

National Community Health Strategy 2017-2022

Government of the Republic of Malawi (2017) CC

The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the provision of basic health services in rural and urban communities with the participation of people who live there. Historically, Community Health has significantly contributed to im... more

Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

Home visits versus fixed-site care by community health workers and child survival: a cluster-randomized trial, Mali

World Health Organisation (WHO) (2024) C_WHO

Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies, hinder progress in further reducing morbidity and m... more

Community health workers to improve uptake of maternal healthcare services: A clusterrandomized pragmatic trial in Dar es Salaam, Tanzania

Geldsetzer, P.; Mboggo, E.; Larson, E.; et al. (2019) CC2

PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768 Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to de... more

The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

Kigume, R.; Maluka, S. (2021) CC2

Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study... more

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Promouvoir des Soins de Proximité en Afrique : L'exemple de la Médecine Générale Communautaire au Bénin; Promotion of community-based care in Africa: example of community general practice in Benin

Roland Caplain, Ismaïl Yacoubou, Didier Adedemy, Alidou Sani, Sandrine Takam, Dominique Desplat Cairn Info (2014) C2

Des efforts considérables ont été menés pour apporter aux populations rurales du continent africain des soins de base. Mais la qualité de ces soins reste aujourd’hui peu satisfaisante car le médecin généraliste est le plus souvent absent en première ligne. Cette situation est paradoxa... more

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Guidelines on Community DOTS Implementation
recommended

National Tuberculosis Control Program, Cambodia Ministry of Health (2004) C1

Guide to community engagement in WASH
recommended

Niederberger, E.; S. Ferron and M. O'Reilly Oxfam (2016) C1

A practioner's guide, based on lessons from Ebola. This guide is a compilation of best practices and key lessons learned through Oxfam’s experience of community engagement during the 2014–15 Ebola response in Sierra Leone and Liberia. It aims to inform public health practitioners and programme ... more

Guidelines on Community DOTS Implementation recommended

Guide to community engagement in WASH recommended

Guidelines on Community DOTS Implementation
recommended

Guide to community engagement in WASH
recommended