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...cation, 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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Advising principles. The purpose of this document is to support competent authorities in charge of IHR implementation to improve national capacities for the prevention, detection and control of events, by strengthening communications and coordination between points of entry and the national health s...urveillance system
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Study Report August 2014
Curatio International Foundation (CIF) and the Association Tanadgoma would like to acknowledge the financial support provided by GFATM under the project “Establishment of evidence base for national HIV/AIDS program by strengthening of HIV/AIDS surveillance system in t...he country” (GEO-H-GPIC), which made this study possible.
The report was prepared by Dr. Ivdity Chikovani, Dr. Natia Shengelia, Lela Sulaberidze (CIF) and Nino Tsereteli (Tanadgoma).
Special thanks are extended to international consultants – Ali Mirzazadeh (MD, MPH, PhD Postdoctoral Scholar, University of California, San Francisco Institute for Health Policy Studies & Global Health Sciences) for his significant contribution in study preparation, protocol and questionnaire design and data analysis and Abu S. Abdul-Quader (PhD, Epidemiologist, Global AIDS Program Centers for Disease Control and Prevention) for his valuable input in refining methodology and overall guidance during the study implementation.
Special thanks are extended to international consultants – Abu S. Abdul-Quader (PhD, Epidemiologist, Global AIDS Program, Centers for Disease Control and Prevention) for his valuable input in refining methodology and overall guidance during the study implementation and Ali Mirzazadeh (MD, MPH, PhD Postdoctoral Scholar, University of California, San Francisco Institute for Health Policy Studies & Global Health Sciences) for his significant contribution in the NSU study preparation, protocol and questionnaire design and data analysis.
Authors appreciate a highly professional work of Tanadgoma staff: the survey coordinator KhatunaKhazhomia; the interviewers: Ketevan Tchelidze, Nino Kipiani, Koba Bitsadze, Kakhaber Akhvlediani, ZazaBabunashvili, Rati Tsintsadze and the social workers: Archil Rekhviashvili, Tea Chakhrakia, Irina Bregvadze, Kakhaber Kepuladze, Ketevan Jibladze and Shota Makharadze for their input in the recruitment process.
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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban areas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the ...township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis.
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Senegal has adopted the World Health Organization–Joint United Nations Programme on HIV/AIDS recommended 90-90-90 targets.5 The adoption of this strategy means that the country is expected, by 2020, to have 90% of its population living with HIV diagnosed, 90% of all those diagnosed receiving susta...ined HIV treatment, and 90% of those receiving antiretroviral therapy having suppressed viral load measures.5 To achieve these outcomes, having good clinical laboratory services for diagnosis and follow-up will be critical.6 More specifically, investments will be needed to improve laboratory infrastructure, and to facilitate the access and availability of routine viral load and early infant diagnosis (EID) measures through the implementation of point-of-care (POC) diagnostic platforms along with an efficient and sustainable quality assurance programme.
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A wide range of potential enablers and barriers were identified for influencing progress for the scale-up of severe wasting services within national health systems. Findings were categorised according to the six pillars of WHO’s health system strengthening framework.
This National Health Policy has 5 objectives, namely
i. To strengthen the healthcare delivery system to be resilient
ii. To encourage the adoption of healthy lifestyles
iii. To improve the physical environment
iv. To improve the socio-economic status of the population
v. To ensure sustainable f...inancing for health
These objectives shall collectively ensure that there will be improved alignment, complementarity and synergies within and across all public sector ministries as well as with other stakeholders, towards achieving the national health goal.
The policy shall therefore ensure that MDAs and other identifiable organizations work within the principles of the Health-in-All Policy and the One-Health Policy frameworks (WHO), to achieve the desired healthy life status of people living in Ghana.
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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...llenge 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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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to 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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This Eye health strategic plan presents the Ministry of Health’s five
year proposed strategies for eye care in Kenya. It sets the strategic
direction for the National Eye Health Care System and presents
information on the priorities, objectives and indicators that the
Ministry has adopted espe...cially with regard to the main eye diseases
and conditions in the country and health system strengthening.
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Following the 2014 Euromaidan Revolution, Ukraine embarked on a national reform program to reduce widespread corruption within government. In the health sector, the government introduced several complementary reforms that aimed to improve the health outcomes of Ukrainian citizens, but designed in su...ch a way that they would also reduce corruption. The reforms included reconfiguring primary care financing and essential medicines reimbursement under the newly formed National Health Service of Ukraine; raising the remuneration of health professionals; introducing a transparent, merit-based, process for medical university admissions; and initiating development of an eHealth digital records system.
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Implementation guide for national, district and facility levels.
This implementation guide contains practical guidance for policy-makers,
programme managers, health practitioners and other actors working to
establish and implement quality of care (QoC) programmes for maternal,
newborn and child ...health (MNCH) at national, district and facility levels.
It is intended to help anyone, throughout the health system, who wants
to take action to improve the QoC for MNCH.
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Since the beginning of the Ukraine crisis on 24 February 2022, WHO has supported Government-led efforts and initiatives alongside key partners on the ground. Building on efforts to date, and working alongside Bulgaria’s health authorities to bring added value to existing mechanisms, the WHO Countr...y Office Bulgaria, the WHO Regional Office for Europe and the WHO Health and Migration Programme, in close collaboration with the Ministry of Health of Bulgaria and key partners, undertook a joint review mission to support Bulgaria, with a focus on addressing the health system needs of refugees, migrants, asylum seekers and vulnerable host populations in Bulgaria.
The assessment team developed this report on the key findings and a package of potential interventions based on the opportunities identified and the need for technical support and assistance. The report summarizes concrete areas of work for which collaborations can be further strengthened. The joint review team identified key recommendations for consideration across 8 priority areas. The report and the outcomes of the review mission serve as a basis for future technical collaboration in the area of refugee health, to address the health needs of refugees and third-country nationals fleeing from Ukraine.
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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 health systems has proved to be complex and continue...s 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 Global Status Report on Noncommunicable Diseases (NCDs) 2014 by the World Health Organization outlines the global impact of NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are responsible for a significant portion of global mortality, particular...ly in low- and middle-income countries.
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