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Category
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Toolboxes
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2
A Reference Guide for Program Managers and Policy Makers. Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportun
...
e moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale
more
Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals
Zulfiqar A. Bhutta, Zohra S. Lassi, George Pariyo and Luis Huicho
World Health Organization WHO; Global Health Workforce Alliance
(2010)
C_WHO
A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems
Alliance Report
Participation of community
...
health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals.
more
Community Empowerment in Health Uganda
Edward O'Neil Jr
The Brookings Institution’s International Volunteering and Service Initiative
(2009)
C1
Based on further analysis of the 2004 Kenya Service Provision Assessment Survey
Community Health Workers in Sub Saharan Africa
recommended
A booklet on how CHWs were addressing eye health across Africa based on desk research and a survey in 23 countries
Glob Health Sci Pract; March 24, 2017, Vol. 5, No. 1, pp. 44-56
Evidence for improving community health supply chains from Ethiopia, Malawi and Rwanda. Journal of Global Health vol. 4 No.2 (2014)
This Policy for community-based health insurance answers the will of the Rwandan government to popularize the fundamental aces of the current policy. This document serves as an update to the first p
...
olicy that was elaborated and published in 2004, and integrates all the changes that have occurred in the process since then. This new version of the policy for community based health insurance contributes to the fulfillment of the same objectives as the EDPRS and the Millennium Development Goals (MDG). It integrates system experiences but more especially the devices adapted to the challenges with which community base health insurance are confronted at present.
more
The seven essential features of practice for scaling up are described with great clarity. They are practical and universal, and encourage local innovation. They include policy, funding and local management structure, as well as working with all possible partners and developing local context adaptati
...
ons. The case studies give ideas and inspiration to develop new programmes and find ways around obstacles in existing programmes, especially through involving those with most at stake including users and their families and local community leaders
more
Dziva Chikwari et al. Implementation Science (2018) 13:70 https://doi.org/10.1186/s13012-018-0762-5
ت، ّالرعاية الصحية المجتمعية، بما يتضم."19كوفيد-′′في سياق جائح
Recognizing the importance of the critical role of community health in disaster management, the Amref health Africa has
developed this operational
...
guide to provide policy direction on COVID-19 response at community level. This guide has
been developed in collaboration with all the implementing countries in supporting prevention and control of COVID-19.
With a strong community COVID-19 response system at community level, we can all contribute to prevention and control
of COVID-19, and thereby improve health and livelihoods for all people
more
This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional
...
experience, the report shows how community health workers save lives and improve quality of life and how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
more
Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and
...
community reintegration, there is a need to understand research findings on community-based interventions that focus on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
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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
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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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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
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, 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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The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the
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implementation and expansion of community-based service delivery in different countries.
Countries were selected for their geographic diversity, type of service delivery model, and programmatic scale-up.
This brief reviews Malawi’s community health model to inform future policy, program design, and implementation in other countries.
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Community Mental Health Policy
recommended
Public Health is the science field dedicated to promoting health and well-being, and preventing disease within the human population to ultimately increase the quality of our livelihood and life span
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. Public Health does not focus on individual patients or diseases, but rather a given population and health system. The discipline is community-centered in its interventions and seeks to improve the health status of whole populations...
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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 commu
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nities 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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Retention of knowledge and application within the community one year later
Training Material - Power Point
The harmonized training package for Point-of-use-fortification using micronutrient powders has been developed to guide in training frontline health workers. The micronutrient powders will be distributed at the
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health facilities where instructions on use will be provided by Health Care Providers. Community Health Volunteers will educate, counsel, and mobilize caregivers at the community level to visit health facilities for nutrition assessment and provision of the micronutrient powders.
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Primary Health-Care Services
recommended
In health emergencies as in periods of stability, restoring access to primary health-care services is a priority in so far as many
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health problems can be dealt with by means of preventive care and
conventional therapy. Depending on the context, the ICRC must often take action in this area, taking into account the level of emergency, the involvement of other actors, the possible evolution of the situation and the organization's operational strategies.
more
Training manual
This learning paper describes Malaria Consortium’s experience with Integrated Community Case Management (ICCM) in malaria prevention and treatment in Mozambique and Uganda. ICCM is an approach where com
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munity-based health workers are trained to identify, treat, and refer complex cases malaria (and other diseases) in children
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International Journal of Mental Health Systems2011,5:17http://www.ijmhs.com/content/5/1/17
This provisional Facilitator's Kit provides a complete framework for a 3-day training on Community Preparedness for Reproductive Health and Gender. The goal is to build
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community capacity to prepare and respond to risks and inequities faced by women and girls during emergencies.
more
PLoS ONE 11(1): e0144662. doi:10.1371/journal.pone.0144662
Community-Based Rehabilitation Services in Low and Middle-Income Countries in the Asia-Pacific Region: Successes and Challenges in the Implementation of the CBR Matrix
Adela Cayetano, R.D.; and J. Elkins
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2016)
CC
Conclusion: CBR has improved the quality of life, access to medical services, functional independence, autonomy, community inclusion, and empowerment of people with disabilities in LMICs in the Asia
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-Pacific region. However, challenges in the implementation of CBR remain. These include lack of awareness and understanding of CBR, and physical, environmental, socio-economical and personal barriers.
more
Transgender HIV/AIDS Health services
TargetHIV
(2019)
C2
Best Practices Guidelines
Accessed: 06.11.2019
COVID-19 & Community Health Workers
recommended
2-Day Orientation training Orientation Training, 1 Febr. 2021
Community Health Workers (CHWs) are an essential part of the Partnership to Accelerate COVID-19 Testing (PACT) Initiative • Africa CD
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C set up PACT to drive forward the Africa Union Joint Continental Strategy for COVID-19
Available in English, French and Arabic
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Background paper 8
The Independent Panel for Pandemic Preparedness and Response
May 2021
As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed
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across all domains of quality health services: effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community
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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 challenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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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 su
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pervision is a holistic concept that encompasses three 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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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
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) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
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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 d
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isease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Prevention and Recognition of Obstetric Fistula Training Package, Module 10: The Roles of Families, Community and the Health Care System
EngenderHealth; Fistula Care; USAID; IntraHealth
(2008)
Module 10: The Roles of Families, Community and the Health Care System in Prevention and Care for Women with Obstetric Fistula
Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WAS
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H) services in all health care facilities. Such services are needed to provide quality care, ensure adherence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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This journal is funded by CBM
This Community Health Systems (CHS) Catalog country profile is the 2016 update of a landscape
assessment that was originally conducted by the Advancing Partners & Communities (APC) project
in 2014
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. The CHS Catalog focuses on 25 countries deemed priority by the United States Agency for
International Development’s (USAID) Office of Population and Reproductive Health, and includes
specific attention to family planning (FP), a core focus of the APC project.
The update comes as many countries are investing in efforts to support the Sustainable Development
Goals and to achieve universal health coverage while modifying policies and strategies to better align
and scale up their community health systems.
The purpose of the CHS Catalog is to provide the most up-to-date information available on community
health systems based on existing policies and related documentation in the 25 countries. Hence, it does
not necessarily capture the realities of policy implementation or service delivery on the ground. APC
has made efforts to standardize the information across country profiles, however, content between
countries may vary due to the availability and quality of the data obtained from policy documents.
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The WHO Quality Health Services: a planning guide focuses on actions required at the national, district and facility levels to enhance quality of health
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services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognizes that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
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Delivering quality health services: A global imperative for universal health coverage
Kieny, Marie-Paule; Evans, Timothy Grant; Scarpetta, Stefano; Kelley, Edward T.; Klazinga, Niek; Forde, Ian; Veillard, Jeremy Henri Maurice; Leatherman, Sheila; Syed, Shamsuzzoha; Kim, Sun Mean; Nejad, Sepideh Bagheri; Donaldson, Liam
World Health Organization (WHO), Organisation for Economic Co-operation and Development (OECD), and The World Bank
(2018)
C_WHO
Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, med ... ication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
Today, inaccurate diagnosis, med ... ication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
Indian Journal of Psychiatry 56(3), Jul‐Sep 2014; DOI: 10.4103/0019-5545.140615
This document presents an integrated strategy for mental health system development that will lead to enhanced service delivery, improved outcomes, and improved human rights for people with mental disorders.
By using the practical guidance provid
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ed in this document, countries can ensure that their mental health systems are not haphazard, but rather, the products of careful consideration and planning.
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This guide is intended to support national governments developing their national deployment and vaccination plans (NDVPs) for COVID-19 vaccines by outlining the roles, needs and opportunities for community
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health workers (CHWs) to contribute. This note builds on and is structured to align with the Guidance on developing a national deployment and vaccination plan for COVID-19 vaccines. By providing CHW-relevant considerations for the VIRAT Tool, this document aims to support national governments in developing robust NDVPs for introducing COVID-19 vaccine(s) that leverage all the community-based deployment, implementation and monitoring tools at their disposal.
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Since the emergence of COVID 19 in December 2019, various public health responses measures have been implemented to control the pandemic. Among measures taken by the Africa CDC was the launch of PACT initiative to accelerate COVID 19 testing. Key to
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the initiative is the engagement of Community Health Workers (CHWs) in risk communication and community engagement (RCCE), surveillance activities for early case identification, contacts tracing and in facilitating referrals for testing and continuum of care.
As of 31 May 2021, Through PACT support, over 17154 CHWs have been trained and locally deployed in 24 AU Member states. The PACT supported CHWs visited more than 2,568,654 households for community engagement activities, active case search and contact tracing, identified 1,618,601 Contacts, 710,167 COVID 19 suspect cases based on the standard case definition and facilitated referrals for 553053 (78%) suspect cases for testing. These efforts were crucial for early identification and isolation of cases in limiting further transmission.
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The Community Health Systems (CHS) Catalog is a resource that provides information on community health
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program workers, and interventions for the 25 countries deemed priority by USAID’s Of of Population and Reproductive Health. It comprises a compilation of 25 country profiles developed from a desk review of community health policies, strategies, a related documentation.
This document summarizes country trends drawn from the CHS Catalog and highlights interesting and relevant findings
about the global community health policy landscape.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle
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-income countries (LMICs); however, little is known about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Human Resources for Health201816:49; https://doi.org/10.1186/s12960-018-0315-7
This compendium collates current tools and resources on quality improvement developed by the WHO Service Delivery and Safety Department and provides examples of how the tools and resources have been applied in country settings. The target audience for this document are ministries of
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health, facility quality improvement teams, researchers and development agencies. WHO technical programmes, regional and country offices can also use the document in their technical cooperation work with the identified audience. Those working to improve the quality of health service delivery can also make good use of this resource
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A stated objective of WHO’s European Mental Health Action Plan 2013–2020 is to ensure better information and knowledge for service planning, development, monitoring and evaluation, including requesting Member States to report on the indicato
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rs in the Plan.
Progress towards achieving the internationally agreed mental health objectives and targets is monitored in the periodic WHO Mental Health Atlas, which collates global information on mental health policies, resources and services.
This booklet provides a snapshot of the situation in countries in the WHO European region with regard to a number of core mental health targets and indicators, derived from the WHO’s Mental Health Atlas 2017.
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The CB MHPSS operational guidelines were developed in response to emerging evidence on the determinants of children’s resilience, lessons learned from the evaluation of existing approaches, and the unique challenges that today’s crises pose for children’s safety, wellbeing and optimal developm
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ent.
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