Community Health Workers

Health Workers’ Role in Health Service Integration

Mesrak BelatchewIn the past decade, the global health field has seen a number of interventions that tried to integrate health services for various purposes. Integrating family planning and HIV services have helped countries make use of the resources available for the latter to expand the scope and coverage of services. TB and HIV service integration is another example of synergy to strengthen both programs. The advantage of integration for consumers is clear: patients get comprehensive services, whether in the community or at health facilities.

Focusing on health workers
Through the years, we have learned that it’s vital to strengthen the existing health system as a whole. In integrating health services, these initiatives bring a welcome focus on the key role of health workers who provide services across the system. Read more »

Community Health Workers: Meeting the Unmet Need for Family Planning in West and Central Africa

Sara Pacqué-MargolisA recent New York Times article featured an updated United Nations forecast that projects the world’s population will reach 10.1 billion by the end of the century, rather than stabilizing at nine billion midcentury as previously predicted. In part, these high rates of population growth are fueled by lower than expected declines in fertility in some of the poorer regions of the world—with the slowest fertility declines observed in West and Central Africa.

Behind the data
Demographers and other global health professionals argue that these sustained high rates of fertility and population growth are the result of a weakened commitment to family planning (FP) programs in the last two decades following a significant focus on FP during the 1970s and 1980s. Read more »

Stepping into the Spotlight: Reflections on Community Health Workers

Crystal NgThe focus of community health worker (CHW) discourse seems to have changed, and in my opinion, for the better. Whereas it previously seemed to me that global health conferences and literature focused primarily on training and task-shifting for CHWs, a recent meeting sponsored by the CORE Group—the implementing organization for the USAID Child Survival and Health Network Program—demonstrated that the field is now taking a more comprehensive view, including CHWs as a natural and key part of child survival and maternal and child health discussions.

Applying human resources management to CHWs

Throughout the sessions, the need to consider strategies for managing the development and performance of CHWs as part of a community health system came up repeatedly. Read more »

Strengthening the Mental Health Workforce with eLearning

Roos KorsteSome countries have only one psychiatrist, and as many as half of developing countries have fewer than five mental health researchers. The World Health Organization’s calculations indicate that in low- and middle-income countries more than 239,000 additional mental health workers are needed, but only 54.5% of all low-income countries have specific psychiatric education.

One approach to addressing these shortages is through eLearning.

Academic courses and degrees
There are many institutes and companies throughout the world that offer online degrees and certificates, but the education level, cost, and international recognition varies. Read more »

Model Families to Model Country: Community Workers Help Scale Up Ethiopia’s Health Program

Mesrak BelatchewIn a typical farmhouse scenario, families live in single-room homes—made of straw, wood, and mud—together with their cattle and other animals. They cook in the same room and do not have latrines or isolated waste disposal facilities. However, Ethiopia’s “model families”—a cornerstone of the country’s successful Health Extension Program (HEP)—build separate kitchens, arrange a place for their cattle outside the family tukul, and dig latrines.

Empowering families with healthy behaviors
Training model families is one of the HEP’s important strategies, and is adapted from Paul Lazarsfeld’s and Everett Rogers’ theories of mass communication and diffusion of innovation. Read more »

Retaining Community Health Workers in Ethiopia

Mesrak BelatchewIn a recent New York Times opinion, Tina Rosenberg asked “What makes community health care work?” Her commentary highlights the important elements for sustaining community health work in developing countries—careful financing, using teaching as part of the sustainability structure, supervision and training, working with the government, and scaling up according to the program and country context—and refers to the rich experiences of BRAC in Bangladesh.

Ethiopia’s health extension worker (HEW) initiative, established in 2004, is another example of a successful program in sub-Saharan Africa. Developed and implemented by the Federal Ministry of Health in collaboration with the Ministry of Education, the HEW program has evolved both in scope and scale to accommodate new health initiatives. Read more »

Haiti Prioritizes Human Resources for Health

On Wednesday, I attended the Global Health Council Conference plenary session entitled "After the Earthquake: Towards Building a New Haitian Health System”, in which the Haitian Minister of Health, the Honorable Dr. Alex Larsen, discussed Haiti’s number one health priority—building the country’s human resources for health.

Dr. Larsen and partners of the Haitian Ministry of Health conveyed the futility of developing infrastructure and obtaining commodities without simultaneously bolstering the healthcare workforce. He mentioned three cadres of health workers that are currently in particularly high demand: community health workers, midwives, and nurse anesthesiologists. Read more »

Global Health Workforce News of Interest

Health worker in UgandaHere are five articles I found particularly interesting this week:

Effect of Peer Health Workers on AIDS Care in Rakai, Uganda
This article in the PloS ONE journal reports on the findings of “a cluster randomized trial to assess the effect of community-based peer health workers (PHW) on AIDS care of adults in Rakai, Uganda.” The authors conclude that “PHWs may be an effective intervention to sustain long-term ART in low-resource settings.”

Over 2,000 Health Workers Get Free Phones
The New Times (Rwanda) reports that community health workers in Karongi District “will get free mobile phones as part of government’s efforts to boost the health sector through the use of science and technology.” The phones “are part of an ongoing countrywide campaign to ensure efficient and timely submission of monthly medical reports to the Ministry of Health.”

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