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 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. In order to extend service delivery to all communities, the NHP calls for all health workers (whether c...ommunity-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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Primary Care: The Community Health System
Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The ‘Introduction to Information and ...Communication Technology and eHealth’ course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.
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Health care and social service systems are facing exceptional demands at this time. Evidence is emerging that the COVID-19 pandemic is disproportionately impacting low-income neighborhoods, communities of color, immigrant and other economically and medically vulnerable patients. These are the patien...ts and communities Community Health Workers (CHWs) are best prepared
to serve. This workforce is defined by their connection to these populations and by their ability to communicate in linguistically and culturally appropriate ways.
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Community health workers (CHWs) play a vital role in health service delivery, especially in countries with less resilient health systems. During any outbreak CHWs are relied on to help control the spread. However, they are often the last in line to receive necessary health products and protective eq...uipment, which affects their ability to safely serve their communities.
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The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the
provision of basic health services in rural and urban communities with the participation of people who live there.
Historically, Community Health has significantly contributed to im...provements in Malawi’s health outcomes in particular
attainment of MDG4. However, the community health system faces resource constraints and inconsistencies around quality
of service – which negatively affect health outcomes.
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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 health, and other development initiatives. This policy has been developed at an opportune moment, as Rwand...a 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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This curriculum was designed to train newly recruited health care workers (HCW) in the basic knowledge and skills needed to improve different HIV services within the health facility including identification, linkage, retention and support. In addition to HIV basics, the training has supplementary un...its focused on PMTCT, psychosocial support, opportunistic infections, tuberculosis and HIV, nutrition and family planning in order to give a more well-rounded and comprehensive training of related topics.
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Barriers to the prompt and effective diagnosis and treatment of malaria exist at both the community and health facility level. Household surveys measure malaria case management at the population level with standard indicators that assess treatment-seeking behavior, access to diagnostic testing, and ...access to appropriate treatment. Performance on these indicators varies widely from country to country. Among countries with Demographic and Health Surveys (DHS) or Malaria Indicator Surveys (MIS) completed between 2014 and 2016, advice and treatment was sought for a median of 47% of children under age 5 with fever.
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Health systems the world over have embraced the value of community health workers (CHWs) in extending essential services to the community level, improving health equity and progressing toward universal health coverage. Governments now have an opportunity to institutionalize CHW programs and professi...onalize this essential cadre of the health workforce. What will it take to ensure CHW programs, at scale, can achieve their full potential?
Fortunately, policymakers, funders, NGOs, and other partners seeking to design, revamp, or strengthen CHW programs have a suite of tools at their disposal. One of the longest-standing and most rigorously field-tested of these tools is the Community Health Worker Assessment and Improvement Matrix (CHW AIM), an assessment tool which can be used to design, evaluate and strengthen CHW programs.
You can find this assessment tool on this page here. The matrix is also downloaded on MEDBOX, but if you want, you can register for free and get the matrix. After that follow the points underneath.
accessed 23.07.2021
also available in [Français] [Español]
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Community health workers (CHWs) serve as a very important direct link between patients, communities and health services. As trusted on-the-ground support to community members, they therefore expand access to essential healthcare information as well as available treatment and prevention programmes.
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This course book provides appropriate, cost-effective, and sustainable targeted learning for the large numbers of emerging community health workers in South Africa.
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The guide is especially appropriate for settings where the provision of medical, diagnostic and support services is sparse or lacking. It covers adult and child mental health problems, as well as childhood developmental disorders. It includes information and guidance on dealing with mental health cr...ises and emergencies and identifying mental health and developmental problems, together with simple intervention strategies, including suggestions for parents and family members to use themselves. It outlines strategies for Community Health Workers to employ in promoting mental health and in raising their community’s awareness of mental health problems
Accessed July 4, 2019
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The object of this bill is to provide for a legal framework to promote the existence of Community Health Workers (CHWs) and to provide for clarity in the role and responsibilities assigned to CHWs in the Health sector and to promote and strengthen service delivery at the Community level. ... The law will regulate training, certification and registration and set minimum qualifications and standards and working conditions for the CHWs.
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The mhGAP community toolkit: field test version is an integral part of WHO's Mental Health Gap Action Programme (mhGAP), and aims at scaling up services for people with mental health conditions to achieve universal health coverage.
The toolkit provides guidance for programme managers on how to i...dentify local mental health needs and tailor community services to match these needs. It offers practical information and necessary tools for community providers to promote mental health, prevent mental health conditions and expand access to mental health services.
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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 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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This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 to 2016. It examines the national dimension of reforms but focuses above all on implementation and results in the economically fragile district of Caraba...yllo, in northern Lima.
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The community-BFCI (c-BFCI) manual has been developed to facilitate training of CHVs and stakeholders providing nutrition sensitive services at community level. The manual covers a wide range of topics: basic nutrition, exclusive breastfeeding, complementary feeding, Breast Milk Substitutes Act, gro...wth monitoring and promotion, early childhood development and stimulation, household food and nutrition security and establishment of baby friendly communities.
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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...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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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...d contribute to prevention, care and support services in their communities
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