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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. Howe
...
ver, 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.
more
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing
...
countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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The guide aims to provide health and DRM practitioners, planners and policymakers across sectors with targeted information to help them strengthen national health systems and integrate the risks of
...
disease outbreaks in national DRR strategies
The following are some of the principles and approaches that have been based on lessons learned to date and may be considered to ensure effective all-hazards health EDRM, including prevention and preparedness for disease outbreaks, are addressed as part of the multihazard, multisectoral approach to developing or updating DRR strategies
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While motivational factors vary, opportunities for career advancement, stimulating and challenging tasks, opportunities for promotion, and co-worker recognition are core factors that can engender retention of rural health workers. Interventions are
...
required to enhance rural health worker motivation and retention, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. Strategies around retention need to be addressed as these would better enable rural primary health workers to cope with the challenging conditions they work in rural areas.
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PLoS ONE 18(5): e0285031. https://doi.org/10.1371/journal.pone.0285031
The study aims to integrate HPV vaccination into routine care in adolescent HIV clinics. To achieve success, we will co-design a package of implementation strategies using a previously successful implementation research approach
...
developed for cervical cancer prevention in LMICs: the Integrative Systems Praxis for Implementation Research (INSPIRE). INSPIRE is a novel, comprehensive approach to develop, implement, and evaluate implementation science efforts
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The Lancet Infectious Disease Volume 25, Issue 2e77-e85February 2025
In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financi
...
alization in the
health domain could be described as the uncontrolled expansion of finance along various lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
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This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (
...
SDGs). The findings reveal wide disparities in governments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middleincome
countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, it will not be sufficient on its own. Effective responses also
require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDGs.
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Bhana A et al. Journal of the International AIDS Society 2021, 24(S2):e25713
This is one of seven Medical Peace Work courses.
There is strong evidence of the impact CHWs can have on health outcomes for their communities. Justification for investment in in CHWs has been well established, but there remain questions about how to find the resources to do this sustainably. Real
...
and practical challenges to building and supporting a strong community health workforce persist- challenges that existed before Ebola, but in many cases have become even worse
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Glob Health Sci Pract; March 24, 2017, Vol. 5, No. 1, pp. 44-56
Sexual violence is a major problem in South Africa, with studies showing that up to one in four women have been raped in their lifetime.
BMZ Papier 1
Gesundheit ist nicht nur Voraussetzung für ein selbstbestimmtes Leben, sondern auch essenziell für die gesellschaftliche und nachhaltige wirtschaftliche Entwicklung in unseren Partnerländern. Die gegenwärtige COVID-19 Pandemie zeigt, welche Gefahren von Infektionskrankheiten ausge
...
-hen. Der Erreger der Pandemie SARS-CoV-2 gibt auch einen Hinweis auf die Bedeutung zoono-tischer, also zwischen Tier und Mensch übertragbarer, Krankheiten. Es ist zu erwarten, dass diese Art von Erregern in der Zukunft noch häufiger auftreten wird. Eine wachsende Weltbevölkerung, Klimawandel, steigende Mobilität, Vordringen des Menschen in bisher unberührte Lebensräume, industrielle Landwirtschaft und Nutztierhaltung sind Faktoren, die das Risiko für das Entstehen bzw. für eine schnelle Ausbreitung von Krankheitserregern erhöhen
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The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly c
...
ost-effective and improves effectiveness of core public health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
more