This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to do just that. Drawing on the published literature and the operational experi
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ence and expertise of different LMICs, the paper points to six key strategies for success and offers a series of practical tips and suggestions on how to implement each one.
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This publication makes the case for working with men and women, boys and girls, together in an intentional and mutually reinforcing way that challe
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nges gender norms in the pursuit of improved health and gender equality. In addition to providing a definition for the new concept of gender synchronization, this document provides examples of synchronized approaches that have worked first with women and girls, or first with men and boys, and describes interventions that have worked with both sexes from the start. It also provides examples of new and emerging programs that should be watched in the coming years for the knowledge they may contribute to the implementation of gender synchronization.
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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. However, consolidation of CHVs position within formal h
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ealth 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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The Ministry of Health and Family Welfare is committed to ensuring the effective implementation of this strategy, which will contribute to the over
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all wellbeing and health of all adolescent boys and girls of Bangladesh
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