Health Workers
- Care Groups II: A Summary of the Child Survival Outcomes Achieved Using Volunteer Community Health Workers in Resource-Constrained Settings
Care Group projects resulted in high levels of healthy behavior, including use of oral rehydration therapy, bed nets, and health care services. Accordingly, under-5 mortality in Care Group areas declined by an estimated 32% compared with 11% in areas with child survival projects not using Care Groups.
- Task Shifting Provision of Contraceptive Implants to Community Health Extension Workers: Results of Operations Research in Northern Nigeria
With training and supportive supervision, male and female Community Health Extension Workers (CHEWs) in Nigeria safely and effectively provided contraceptive implants, and virtually all clients said they were satisfied. Most CHEWs achieved competency after 5 client insertions. However, the CHEWs provided only an average of 4 insertions per health facility per month. Realizing the true potential of providing implants calls for a context with dedicated providers and robust outreach.
- Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys
Only about 35% of sample households reported receiving immunization, food supplements, pregnancy care information, or nutrition information. Monetary incentives for such product-oriented services as immunization improved performance and may have spillover effects for information-oriented services. Immunization day events and good frontline worker recordkeeping also improved service delivery.
- Female Health Workers at the Doorstep: A Pilot of Community-Based Maternal, Newborn, and Child Health Service Delivery in Northern Nigeria
Deployment of resident female Community Health Extension Workers (CHEWs) to a remote rural community led to major and sustained increases in service utilization, including antenatal care and facility-based deliveries. Key components to success: (1) providing an additional rural residence allowance to help recruit and retain CHEWs; (2) posting the female CHEWs in pairs to avoid isolation and provide mutual support; (3) ensuring supplies and transportation means for home visits; and (4) allowing CHEWs to perform deliveries.
- Predictors of Workforce Retention Among Malawian Nurse Graduates of a Scholarship Program: A Mixed-Methods Study
Several non-remuneration strategies may help improve retention of public-sector nurses: availability of supplies, adequate housing, advancement opportunities, and a positive work environment. A scholarship program with close follow-up of graduates may also help improve retention.
- Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation
During national scale up of iCCM in Rwanda, greater improvements in care-seeking were found in the districts where Kabeho Mwana implemented its model than in the rest of the country. Success was attributed to an emphasis on routine data review, intensive monitoring, collaborative supervision, community mobilization, and, in particular, CHW peer support groups.
- Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India
Emergency contraceptive pills (ECPs) are extremely safe and do not interfere with implantation. Yet many surveyed physicians in India did not know that there are no contraindications to using ECPs, and many had negative attitudes about ECP users. Most were against having ECPs available over-the-counter and wanted to impose age restrictions. Efforts are needed to address such misconceptions that might lead to limiting ECP availability.
- Cell phones and CHWs: a transformational marriage?
Mobile phones can be transformative for community health workers (CHWs) in enhancing their influence and status and helping to solve practical problems. While formal intervention research can help advance mHealth application, most progress will come through a “diffusion of innovation” process.
- Keeping community health workers in Uganda motivated: key challenges, facilitators, and preferred program inputs
In Uganda, community-based health programs using volunteers should focus on strengthening support systems to address transportation and stockout issues and on improving links with the health structure while reinforcing effort recognition, status, and acquisition of new skills.