Community Health Workers in Global Health: Scale and Scalability

Liu, Anne; Sullivan, Sarah R.; Khan, M. Z.; Sachs, Sonia Ehrlich; Singh, Prabhjot

doi:10.1002/msj.20260

Cited by 123 publications

(137 citation statements)

References 36 publications

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“…Examples of most successful interventions that trained and deployed community health workers include the Chines CHW programme in Ding Xian, which started in the 1920s, became vibrant in the 1050s and 60s and by 1972 had trained more than one million barefoot soldiers serving rural communities by providing essential health services with minimal training [7,8]. Their focus was in getting communities to understand and participate in environmental sanitation, health education, immunization and essential primary medical care including first aid.…”

Section: Success Storiesmentioning

confidence: 99%

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Frontline Health Workers Nobel Role in Disease Prevention for Achieving Global Health Security: Why are we not Learning the Lessons?

Kitua¹

2017

J Healthc Commun

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Frontline health workers are trusted, knowledgeable health personnel, who belong to the communities they serve. They are well accepted and relied on by the communities and form the central pillar of effective health systems key to reducing preventable deaths and achieving universal health coverage. They are the foundation of disease intelligence essential to efforts to eliminate diseases and prevent disease outbreak. However, against such important roles and proven cost effectiveness in achieving health outcomes, they are among the most neglected cadre of health workforce in Africa and other parts of the world. They are poorly equipped and remain exposed to disease risks, and except in few countries, receive inadequate training, lack supervision and career development. In addition, they work as unpaid volunteers. Where they have been well recognized and supported to perform their roles, they have proven to be effective, affordable and reliable in achieving health outcomes. We share examples of success stories and important lessons that poor access to health services is not strictly linked with low economic level, but rather reflects a lack of political will and determination by leaders to protect their most vulnerable populations. We urge governments to enshrine health as a fundamental human right in their national constitutions and invest in Primary Health Care by build an army of Frontline Health workers capable of preventing diseases and outbreaks at source, hence saving money for developmental activities and education. We need louder voices to advocate training and maintaining of frontline health workers, especially in resource limited countries.

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Section: Success Storiesmentioning

confidence: 99%

“…From these success stories, we learn that the critical elements required in order to strengthen primary health care in health systems and achieve universal coverage include among others the following [5][6][7][8]19]. …”

Section: Lessons From Success Storiesmentioning

confidence: 99%

Frontline Health Workers Nobel Role in Disease Prevention for Achieving Global Health Security: Why are we not Learning the Lessons?

Kitua¹

2017

J Healthc Commun

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“…Support for storing patient relationship data was first introduced to the OpenMRS data model as part of the OpenMRS 1.0 platform release in 2006. This functionality was introduced in response to the needs of two implementers: Kenya's Academic Model Providing Access to Healthcare (AMPATH) program which needed to record discordant HIV couples for their HIV/AIDS programs and Partners In Health (PIH) OpenMRS deployments, which needed to record patient to Community Health Worker (CHW) relationships as part of their Accompagnateur program [32]. Initially, relationships were unidirectional, meaning that only one participant in the relationship (the patient) was aware of which persons they were linked to.…”

Section: The Openmrs Patient Relationship Modelmentioning

confidence: 99%

Leveraging the Value of Human Relationships to Improve Health Outcomes

Kasthurirathne

Mamlin²,

Cullen³

2017

Appl Clin Inform

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SummaryObjectives: Despite significant awareness on the value of leveraging patient relationships across the healthcare continuum, there is no research on the potential of using Electronic Health Record (EHR) systems to store structured patient relationship data, or its impact on enabling better healthcare. We sought to identify which EHR systems supported effective patient relationship data collection, and for systems that do, what types of relationship data is collected, how this data is used, and the perceived value of doing so. Materials and methods:We performed a literature search to identify EHR systems that supported patient relationship data collection. Based on our results, we defined attributes of an effective patient relationship model. The Open Medical Record System (OpenMRS), an open source medical record platform for underserved settings met our eligibility criteria for effective patient relationship collection. We performed a survey to understand how the OpenMRS patient relationship model was used, and how it brought value to implementers. Results: The OpenMRS patient relationship model has won widespread adoption across many implementations and is perceived to be valuable in enabling better health care delivery. Patient relationship information is widely used for community health programs and enabling chronic care. Additionally, many OpenMRS implementers were using this feature to collect custom relationship types for implementation specific needs. Conclusions: We believe that flexible patient relationship data collection is critical for better healthcare, and can inform community care and chronic care initiatives across the world. Additionally, patient relationship data could also be leveraged for many other initiatives such as patient centric care and in the field of precision medicine. BackgroundAs social animals, humans build complex relationships with one another within the community that they live in [1]. Identifying such relationships between patients and their caregivers, family members/dependents, and healthcare providers can help inform community support structures, identify disease discordance/relationship-based clusters, and improve community health care delivery, thus improving the efficiency, effectiveness, and impact of healthcare [2][3][4].In the United States and other developed nations, patient relationship data are critical for supporting the move towards patient centric and patient controlled care models [5]. Relationship data may also contribute to assessing family health history, which helps promote comprehensive patient and family centered care with the potential to impact individual, family, and population-based outcomes [6].Patient relationship data are also of critical importance for many Low and Middle Income Countries (LMIC), which are defined as countries with a gross national income (GNI) less than 12,736 US dollars per capita in 2014 [7]. In LMIC, relationships play a crucial role in maximizing use of limited health resources by linking patients to various communit...

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“…Human resource constraints within resource-limited settings have increased interest in using frontline workers, such as community health workers (CHWs), to improve MNCH by increasing access, reducing inequities and improving key health indicators in rural settings. 4 In 2011, Kenya introduced its Community Health Strategy, which aims to improve health outcomes, including MNCH, by promoting individual and community health 5 through the use of community health volunteers (CHVs -the name for CHWs in Kenya). To have maximum impact on MNCH, CHVs must regularly reach a high proportion of women and children throughout the continuum of care 6 to deliver key messages and link individuals to services.…”

mentioning

confidence: 99%

Enhancing the capacity and effectiveness of community health volunteers to improve maternal, newborn and child health: Experience from Kenya

Avery

Plessis

Shaw

et al. 2017

Can J Public Health

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OBJECTIVE: To determine whether a simple monitoring and tracking tool, Mwanzo Mwema Monitoring and Tracking Tool (MMATT), would enable community health volunteers (CHVs) in Kenya to 1) plan their workloads and activities, 2) identify the women, newborns and children most in need of accessing critical maternal, newborn and child health (MNCH) interventions and 3) improve key MNCH indicators. METHODS:A mixed methods approach was used. Household surveys at baseline (n = 912) and endline (n = 1143) collected data on key MNCH indicators in the four subcounties of Taita Taveta County, Kenya. Eight focus group discussions were held with 40 CHVs to ascertain their perspectives on using the tool. RESULTS:Qualitative findings revealed that the CHVs found the MMATT to be useful in planning their activities and prioritizing beneficiaries requiring more support to access MNCH services. They also identified potential barriers to care at both the community and health system levels. At endline, previously pregnant women were more likely to have received four or more antenatal care visits, facility delivery, postnatal care within two weeks of delivery and a complete package of care than baseline respondents. Among women with children under 24 months, those at endline were more likely to report early breastfeeding and exclusive breastfeeding for the first six months. These results remained after adjustment for age, subcounty, gravida, mother's education and asset index.CONCLUSION: Our results demonstrate that simple tools enable CHVs to identify disparities in service delivery and health outcomes, and to identify barriers to MNCH care. Tools that enhance CHVs' ability to plan and prioritize the women and children most in need increase CHVs' potential impact.KEY WORDS: Community health workers; maternal health; child health; Kenya; program evaluation La traduction du résumé se trouve à la fin de l'article.

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Community Health Workers in Global Health: Scale and Scalability

Cited by 123 publications

References 36 publications

Frontline Health Workers Nobel Role in Disease Prevention for Achieving Global Health Security: Why are we not Learning the Lessons?

Frontline Health Workers Nobel Role in Disease Prevention for Achieving Global Health Security: Why are we not Learning the Lessons?

Leveraging the Value of Human Relationships to Improve Health Outcomes

Enhancing the capacity and effectiveness of community health volunteers to improve maternal, newborn and child health: Experience from Kenya

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