Health Workers
- 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.
- 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.
- 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.
- 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.
- 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.
- Using Community Health Workers and a Smartphone Application to Improve Diabetes Control in Rural Guatemala
A smartphone application providing algorithmic clinical decision support enabled community health workers to improve diabetes control for a group of patients in rural Guatemala. This approach enables task sharing with physicians and other advanced practitioners for chronic disease care, which is particularly important in low-resource settings.
- A Cluster-Randomized Trial to Test Sharing Histories as a Training Method for Community Health Workers in Peru
Women naturally communicate using life narratives. Through systematic recall and sharing memories of their own childbearing and child rearing experiences, community health workers (CHWs) become engaged and empowered to change their own and other mothers’ health behaviors. Training CHW with sharing histories can improve capabilities as change agents for better child health.
- A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards
Understanding hand hygiene behaviors is critical in hospitals. We developed the HANDS at birth tool—and provide information on its design and implementation–to capture the complex patterns of health care workers’ hand hygiene including hand rubbing/washing, glove use, and recontamination.