More articles from ORIGINAL ARTICLE
- Community Health Worker Program Sustainability in Africa: Evidence From Costing, Financing, and Geospatial Analyses in Mali
Understanding specific program costs through efficiency analyses and geospatial targeting allows national stakeholders to make strategic, targeted investments, making the first steps toward sustainability. Costs required for community health worker programs can be reduced without sacrificing quality, and spending can be geographically targeted to optimize service use by rural populations. Results from Mali provide an example for other sub-Saharan African countries.
- Evaluating Vertical Malaria Community Health Worker Programs as Malaria Declines: Learning From Program Evaluations in Honduras and Lao PDR
Community case management by community health workers has substantially reduced malaria across the Greater Mekong Subregion and Central America. To sustain current and achieve further reductions in malaria, surveillance and delivery platforms must be redesigned to ensure their continued use by key populations.
- The Community Health Systems Reform Cycle: Strengthening the Integration of Community Health Worker Programs Through an Institutional Reform Perspective
Efforts to scale community health worker programs within primary health care systems in 7 countries illustrated that these efforts are best understood as a complex process of institutional reform. Successful scale up depends on a problem-driven political process; requires that models develop solutions that align with resources, capabilities, and commitments of key stakeholders; and emerges from iterative cycles of learning and improvement.
- Galvanizing Action on Primary Health Care: Analyzing Bottlenecks and Strategies to Strengthen Community Health Systems in West and Central Africa
In West and Central Africa, “leaving no one behind” requires strengthening community health systems by increasing health financing, improving supply chain system, and fostering community ownership and partnerships in all settings. Countries with high child mortality rates should improve service delivery through better integration. Galvanizing context-specific country actions is fundamental to improve primary health care services and move toward universal health coverage.
- Measuring Knowledge of Community Health Workers at the Last Mile in Liberia: Feasibility and Results of Clinical Vignette Assessments
We integrated clinical vignettes into routine programmatic supervision to assess community health worker knowledge of integrated community case management in rural Liberia. Results included higher rates of correct diagnosis and lifesaving treatment for uncomplicated disease than for more severe cases, with accurate recognition of danger signs posing a challenge.
- Volunteer Community Health and Agriculture Workers Help Reduce Childhood Malnutrition in Tajikistan
Paired agricultural and health interventions led by volunteer community health workers and community agricultural workers through home visits, community events, and peer support groups proved successful in improving nutrition of children and may be applicable in other contexts.
- Implementation of a Community Transport Strategy to Reduce Delays in Seeking Obstetric Care in Rural Mozambique
Encouraging local transport programs and transport infrastructure in poorly-resourced communities can help improve community access and strengthen engagement with health systems. Mobilizing community resources and leadership to implement a community-based transport scheme in rural Mozambique to support referrals to health facilities can help improve maternal and child health outcomes.
- Applying the Community Health Worker Coverage and Capacity Tool for Time-Use Modeling for Program Planning in Rwanda and Zanzibar
The C3 Tool supports community health worker (CHW) program planning by making tradeoffs apparent between human resources and the services to be provided at varying levels of population coverage. Governments in Rwanda and Zanzibar used the tool, respectively, to optimize CHW time allocation and to estimate how many CHWs were needed to meet universal health coverage goals.
- Health Care Worker Preferences and Perspectives on Doses per Container for 2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia
When providing immunization services, health care workers balance the mandate of achieving high coverage with limiting vaccine wastage. Workers in 3 countries said that containers with fewer vaccine doses for measles and BCG would enable them to immunize all children who present, while reducing concerns about wasting vaccine.
- Effects of a Community-Based Program on Voluntary Modern Contraceptive Uptake Among Young First-Time Parents in Cross River State, Nigeria
Among young first-time mothers, participation in a comprehensive, community-based program led to a 3-fold increase in voluntary modern contraceptive use and other positive changes. These results demonstrate the importance of investing in interventions for this youth population that ideally address a range of priorities across the first-time parent lifestage.