Getting up to speed on community health workers
By Mariam Bhacker
Increasing recognition of the role that community health workers (CHWs) play in health service delivery has spurred the implementation of numerous CHW programs around the world. CHWs help alleviate resource and personnel shortages in national health systems, and with their ability to deliver health services to the most at-need populations, are key actors in the advance towards universal health coverage.
This week saw the launch of the Health Systems Global webinar series with an online panel discussion entitled, “Impact of community health workers: Current evidence base and essential focus areas”, featuring leading thinkers in health systems and CHW research and programming.
Moderated by Diana Frymus of the USAID, Office of HIV/AIDS in Washington, DC and vice-chair of the Health Systems Global community health worker thematic working group, 128 attendees joined Maryse Kok (Royal Tropical Institute), Hermen Ormel (REACHOUT Consortium), Polly Walker (World Vision) and Henry Perry (Johns Hopkins School of Public Health) as they tackled important questions along the evidence to action spectrum: Where is a stronger evidence base needed to support policy development and programmes? And how can existing evidence be better translated into action?
You can cement your understanding with the following collection of CHW resources:
1. Community health workers: An overview
‘Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of their History, Recent Evolution, and Current Effectiveness’ by Henry Perry, Rose Zulliger and Michale Rogers of John Hopkins. Does what it says on the tin.
2. International frameworks and guidelines
The Global Health Workforce Alliance’s Joint Commitment to Harmonized Partner Action for CHWs and FLHWs is a product of the 2013 Third Global Forum on Human Resources for Health (HRH), held in Recife, Brazil, and was informed by three working papers commissioned by the Alliance. Also presented at the Forum was the World Vision-led CHW “Principles of Practice”, which provides a framework for advocacy, programming and partnership between various actors to achieve coordinated national scale-up of CHW programs.
3. Evidence on the efficacy and impact of community health workers
The 2012 ‘Review of CHW Effectiveness for MDGS’ commissioned by the MDG Health Alliance concluded that utilizing CHWs to deliver health services to women and families could potentially save 3.6 million children’s lives each year. Research on the cost-effectiveness of health workers conducted by researchers from KIT Health, Queen Margaret University and the Liverpool School of Tropical Medicine concluded “Yes, if…”.
4. Guidance on implementing CHW programmes
Developing and Strengthening Community Health Worker Programs at Scale from the USAID Global Health Bureau’s Maternal and Child Health Integrated Program (MCHIP) is a comprehensive reference guide for program managers and policy-makers based on peer reviewed and grey literature, key informant interviews and 12 country case studies. Building on this, the One Million Community Health Workers Campaign’s technical task force report provides broad operational and cost considerations for mobilizing support for a large increase in public sector CHW cadres across Africa.
5. Evidence on the barriers and facilitators of CHW performance
Results from the first phase of the five-year multi-country EU-funded REACHOUT study identify contextual factors that influence the performance of close-to-community (CTC) providers and services in Bangladesh, Ethiopia, Indonesia, Kenya, Malawi and Mozambique.
6. The role of CHWs in global health
Support and strengthening of CHWs assists and supports progress in wider global health and development areas, including:
- Health systems
- Universal health coverage
- Maternal and newborn care
- Gender and health policy
To join Health Systems Global’s thematic working group on supporting and strengthening the role of community health workers, please contact Faye Moody.
Mariam Bhacker,
On behalf of the Health Systems Global Secretariat