CGPP Achievement of Community Health Worker Assessment and Improvement Matrix Tool Components

CHW AIM 2018: Revised Programmatic ComponentsCGPP Achievement of Level 3 Functionality
1. Role and Recruitment
How the community, CHW, and health system design and achieve clarity on the CHW role and from where the CHW is identified and selected.
Level 3 achieved
Clarity and clear criteria identified for recruitment and role. Some criteria changed over time.
2. Training
How preservice training is provided to CHWs to prepare for their roles and ensure they have the necessary skills to provide safe and quality care. How ongoing training is provided to reinforce initial training, teach CHWs new skills, and help ensure quality.
Level 3 achieved
Initial training in 4 of 5 programs 3–5 days, maximum was 2 weeks in Angola.
Trainers included CGPP and NGO staff with health facility and government officials and other resource people varying.
Training content in addition to polio, provided broad maternal and child health and social and behavior change skills in most programs.
On-the-job mentoring was the major method of continuing education through CM mentoring, monthly meetings, and annual meetings.
3. Accreditation
How health knowledge and competencies are assessed and certified prior to practicing and recertified at regular intervals while practicing.
Level 3 not achieved because there was no formal certification system.
CM health knowledge and competencies assessed initially and periodically. External program evaluations documented Knowledge, Practice, and Coverage of CMs and verified with community.
4. Equipment and Supplies
How the requisite equipment and supplies are made available when needed to deliver expected services.
Level 3 achieved
Continuous supply of job aids (flip books, registers, writing books, pens, posters, sometimes bicycles).
5. Supervision
How supportive supervision is carried out such that regular skill development, problem solving, performance review, and data auditing are provided.
Level 3 achieved
All country programs addressed supervision at all levels and types.
6. Incentives
How a balanced incentive package reflecting job expectations, including financial compensation in the form of a salary and nonfinancial incentives, is provided.
Level 3 partially achieved
  • CMs were part-time workers and did not receive a salary.

  • In 3 of 5 programs, CMs received a monthly honorarium (underpaid compared to UNICEF).

  • All provided transport/food allowances for campaigns and program meetings.

  • 3 of 5 provided certificates and performance awards.

  • 1 provided free access to health services.

  • All had community recognition.

7. Community Involvement
How a community supports the creation and maintenance of the CHW program.
Level 3 achieved
This was one of the strongest components of the CGPP. All programs demonstrated strong and continuous community involvement.
8. Opportunity for Advancement
How CHWs are provided career pathways.
Level 3 partially achieved
Because the program was vertical and had changing geographic areas, opportunities to advance within the program were limited.
3 of 5 programs reported opportunities in government and community.
Retention was high (86%–95%) in 3 of the programs, 40% in another, no data in the fifth.
9. Data
How community-level data flow to the health system and back to the community, and how they are used for quality improvement.
Level 3 achieved
Data collection tools included community maps, registers of pregnant women and newborns, defaulters, child immunization status, and household visits. Feedback was provided to community and local government and health system. Data were used for problem solving to improve program performance.
10. Linkages to the National Health System
The extent to which the Ministry of Health has policies in place that integrate and include CHWs in health system planning and budgeting and provides logistical support to sustain district, regional, and/or national CHW programs.
Level 3 partially achieved
Because program was vertical and had limited time expectations, it was never fully integrated with the national health system even though CM referrals were made and CMs worked closely with government cadres in all countries.
  • Abbreviations: AIM, Assessment and Improvement Matrix; CGPP, CORE Group Polio Project; CHW, community health worker; CM, community mobilizer; NGO, nongovernmental organization.