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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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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 ... more

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Community Health Extension Workers Strategy in Uganda (2015/16- 2019/20)

Ministry of Health, Republic of Uganda (2016) C1

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Developing and Strengthening Community Health Worker Programs at Scale

Perry, H.; L. Crigler, et al. Maternal and Child Health Integrated Program (MCHIP) (2014)

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 opportune moment to take stock of issues and challenges such programs face and what can be done to make them a... more

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Community Health Workers in Sub Saharan Africa
recommended

Hannah Faal, Rènée du Toit, Henrietta Monye, Ronnie Graham IAPB Africa (2016) CC

A booklet on how CHWs were addressing eye health across Africa based on desk research and a survey in 23 countries

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WHO guideline on health policy and system support to optimize community health worker programmes
recommended

World Health Organization WHO (2018) C_WHO

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 health systems and communities. Successful delivery of services through CHWs requires evidence-based models for edu... more

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National Community Health Worker Strategy in Zambia

Ministry of Health, Zambia (2010) C1

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How effective are community health workers?

Henry Perry; Rose Zulliger John Hopkins Bloomberg University (2012)

An Overview of Current Evidence with Recommendations for Strengthening Community Health Worker Programs to Accelerate Progress in Achieving the Health-related Millennium Development Goals

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Policy for Community Health Workers in Sierra Leone

Government of Sierra Leone, Ministry of Health and Sanitation (2012) C1

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Comprehensive Evaluation of the Community Health Program in Rwanda (FINAL REPORT)

Centre for Maternal and Newborn Health (CMNH), from the Liverpool School of Tropical Medicine (LSTM) (2016) C2

The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo... more

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Access to healthcare through community health workers in East and Southern Africa

Kumar, M.; R. Nefdt, E. Ribaira and K. Diallo UNICEF (2014) C_UNICEF

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Community health workers at the dawn of a new era: 6. Recruitment, training, and continuing education

Meike J. Schleif, Iain Aitken , et al. Health Research Policy and Systems (2021) CC

This is the sixth of our 11-paper supplement entitled “Community Health Workers at the Dawn of New Era”. Expectations of community 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... more

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ENGAGE-TB: integrating community-based tuberculosis activities into the work of nogovernmental and other civil society organizations: training of community health workers and community volunteers

Thomas Joseph, Nathalie Likhite, Lana Syed et al. World Health Organization (2015) C_WHO

Facilitator's Guide. This guide is designed to assist facilitators in training community health workers (CHWs) and community volunteers (CVs) in integrating community-based TB services into their work. The training will help community workers who already provide numerous services to understand TB an... more

Optimizing community health worker programmes for HIV services: a guide for health policy and system support.

World Health Organization WHO (2021) C_WHO

This document synthesizes key elements of the World Health Organization (WHO) normative guidance on health policy and system support for community health worker (CHW) programmes and their application for HIV programmes. Building on relevant elements of HIV guidelines, tools and evidence identified b... more

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A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe & neighbouring countries

C. Folch; P. Fernández-Dávila; J. Palacio-Vieira; et al. European Commission; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT); European AIDS Treatment Group (2020) C2

Accessed: 07.03.2020 A Review of Community Health Worker (CHW) knowledge, attitudes and practices relating to the sexual health of MSM, including existing training materials and manuals in Europe and neighbouring countries (D5.1) Contract 2015 71 01 A behavioural survey for HIV/AIDS and assoc... 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