Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to und...erserved communities, in low-income countries. However, 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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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...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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This is the sixth of our 11-paper supplement entitled “Community Health Workers at the Dawn of New Era”. Expectations of community ..."attribute-to-highlight medbox">health workers (CHWs) have expanded in recent years to encompass a wider array
of services to numerous subpopulations, engage communities to collaborate with and to assist health systems in responding to complex and sometimes intensive threats. In this paper, we explore a set of key considerations for training of CHWs in response to their enhanced and changing roles and provide actionable recommendations based on
current evidence and case examples for health systems leaders and other stakeholders to utilize.
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This module has been developed to provide training and guidance to improve the quality of care and human rights conditions in inpatient, outpatient and community ...medbox">based mental health and related services, following the conduct of a comprehensive assessment using the WHO QualityRights assessment toolkit.
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Slum population in India is growing fast (25.1% decadal growth – Census 2011). Its health and nutrition indicators are worse than that of the non slum urban areas and comparable to that of rural India.
The National Urban ...-highlight medbox">Health Mission (HUHM), launched in 2013, focuses on improving the health of urban slum population through a needs based, city-specific urban health care system that includes a revamped primary care system, targeted outreach, equitable access, and involvement of the community and urban local bodies (ULBs).
The HUHM recognizes that lack of disaggregated data collected at local and/or city level impedes efficient planning with focus on the urban poor, and that data availability is a critical need.
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No publication year indicated
The specific objectives of the plan are to:
- Scale up evidence-based, cost effective interventions through effective strategies within a HSS approach and provide equitable coverage with quality.
- Reduce... neonatal mortality by improved home-based newborn care, early identification of sick newborns and improved access to institutional newborn care of adequate quality.
- Reduce common childhood illness related mortality (due to pneumonia and diarrhoea in all areas and malaria in endemic areas) by improving key family and community practices, community-based early diagnosis and management and referral care for complicated cases.
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This updated Comprehensive Mental Health Action Plan 2013-2030 builds upon its predecessor and sets out clear actions for Member States, the WHO Secretariat and international, regional and national partners to promote mental ...o-highlight medbox">health and well-being for all, to prevent mental health conditions for those at-risk and to achieve universal coverage for mental health services. While the updated action plan includes new and updated indicators and implementation options, the original four major objectives remain unchanged: more effective leadership and governance for mental health; the provision of comprehensive, integrated mental health and social care services in community-based settings; implementation of strategies for promotion and prevention; and strengthened information systems, evidence and research.
In English, French, Spanish, Arabic and Russian available
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a com...pilation of tools, best practices, recommendations and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies
show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young
people, those with pre-exist...ing mental health conditions, health workers, and persons living in vulnerable condi-
tions. Mental health systems and services have also been severely disrupted. A lack of financial and human resource
investments in mental health services, limited implementation of the decentralized community-based care approach
and policies to address the mental health gap prior to the pandemic, have all contributed to the current crisis. Coun-
tries must urgently strengthen their mental health responses to COVID-19 by taking actions to scale up mental
health and psychosocial support services for all, reach marginalized and at-risk populations, and build back better
mental health systems and services for the future.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and ...child mortality. The Government of Nepal has implemented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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LEAVING NO-ONE BEHIND | “A Journey to End NTDs – Elimination and Care” records what we have achieved over the last year and where we are now. It presents our plan of action for the coming years, bringing our ‘traditional’ NTD work together... with ‘Disease Management Disability and Inclusion’ (DMDI), Community Based Inclusive Development (CBID) and Livelihoods. We care for those affected and we’re working to enhance community and government ownership through national
health system strengthening, community engagement and cross-sectoral action. Ultimately, we are working to free future generations from these menacing diseases, improving prevention and treatment, without forgetting those for whom prevention and treatment are too late because they already have a disability.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper ...bute-to-highlight medbox">health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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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 of psychosocial support, including understanding the impact of crisis events, supportive communication, protection issues and self-care.
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J Nepal Health Res Counc 2012 May;10(21):82-87
The main goal of the National Health Plan (NHP) 2017-2021 is to extend access to a basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. I...n order to extend service delivery to all communities, the NHP calls for all health workers (whether community-based, outreach-based or facility-based) involved in the delivery of health promotion, prevention and treatment services to be fully recognised and institutionalized within the health system to ensure efficient use of resources, necessary oversight and quality service provision (regardless of whether the health workers are voluntary or salaried). The first year Annual Operational Plan (AOP) of the NHP 2017-2021 calls for a comprehensive literature review of the situation of all Village Based Health Workers (VBHWs) in the country to inform the development of a comprehensive, institutionalized approach to community health for the country.
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A booklet on how CHWs were addressing eye health across Africa based on desk research and a survey in 23 countries
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...munity-based health workers are trained to identify, treat, and refer complex cases malaria (and other diseases) in children
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This policy will serve as a cornerstone from which to address the accessibility of Community Health (CH) services and to encourage its integration with services for HIV/AIDS, maternal and child ...n class="attribute-to-highlight medbox">health, and other development initiatives. This policy has been developed at an opportune moment, as Rwanda is embarking on the introduction of community-based provision of family planning and non-communicable disease (NCD) services through Community Health Workers (CHWs). These efforts are anticipated to trigger a paradigm change in the way community health services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all.
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The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in ...ttribute-to-highlight medbox">health systems and communities.
Successful delivery of services through CHWs requires evidence-based models for education, deployment and management of these health workers. The guideline is intended as a tool for national policy makers and planners and their international partners to use in the design, implementation, performance and evaluation of effective community health worker programmes. It contains pragmatic recommendations on selection, training and certification; management and supervision: and integration into health systems and community engagement.
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The Community Health Community of Practice (CH CoP) builds on the Institutionalisation Community... Health Conference co-hosted by USAID and UNICEF in Johannesburg in March 2017. Conceived as an ‘open space’ in terms of both contribution and access to knowledge, it aims at gathering practitioners, policy makers, researchers, program implementers and other experts actively involved in the technical or policy development of community health programs in low- and middle-income countries. It offers a network to share your country experience with other countries facing similar challenges; access to global knowledge on community health and its institutionalisation; opportunities for learning, exchanging and debating; constant information on new theoretical, operational or empirical developments in this domain of knowledge. The CoP is facilitated by an international team based in Africa, Asia and Europe. The CH CoP is supported by UNICEF in collaboration with USAID.
accessed 23.07.2021
Collectivity Platform has more group networks to join. The Platform is also available in French.
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