Community Health Workers

Do Lay or Community Health Workers in Primary Health Care Improve Maternal and Child Health and Tuberculosis Outcomes?

This summary is based on an update of a Cochrane systematic review published in 2010. The summary focuses on the effects of lay health worker interventions in improving maternal and child health and tuberculosis outcomes. [from author]

Can the Deployment of Community Health Workers for the Delivery of HIV Services Represent an Effective and Sustainable Response to Health Workforce Shortages?: Results of a Multicountry Study

This study aimed to evaluate the contribution of community health workers with a focus on identifying the critical elements of an enabling environment that can ensure they provide quality services in a manner that is sustainable for expanding the health workforce to scale up HIV services. [adapted from author]

Community-Based Health Workers Achieve High Coverage in Neonatal Intervention Trials: a Case Study from Sylhet, Bangladesh

This article provides key lessons learned from a large-scale community-based efficacy trial of a two-tiered system of community-based workers to deliver a package of essential maternal and newborn-care interventions and one of three umbilical cord-care regimens in Bangladesh.

Communtiy Health Workers as a Cornerstone for Integrating HIV and Primary Healthcare

This study used both qualitative and quantitative measures to evaluate the role of the communtiy health workers in enhancing the interface between primary health care oriented health services and households in responses to HIV
and AIDS. [from author]

Community-Based Access to Injectables: an Advocacy Guide

Studies and field observations have found that community health workers (CHWs) can provide injectables safely and that community access to injectables attracts new contraceptive users. This guide is designed to assist the many health professionals and advocates who are interested in making injectable contraceptives more widely available, especially for women with little or no access to health facilities. The guide describes six steps that advocates can take to support policy change to permit CHWs to provide injectables. [from summary]

My Work as a Midwife

This 2:21 video introduces Ade Yanarsih’s work and challenges as a local health worker and community midwife in Kampung Cirendeng, Indonesia.

My Motivations: a Day in the Life as a Health Worker in Xachmochan

This 2:56 minute video is part of the Good Goes campaign and showcases the work of Felix Aguilar Ramirez, a community health worker in the Xachmochan village in Guatemala.

Management of Sick Children by Community Health Workers: Intervention Models and Programme Examples

This report examines approaches for the community management of sick children, specifically antimicrobial treatment, through the use of community health workers or their equivalent. It is based on an extensive review of literature, including peer-reviewed studies, reports, programme descriptions and program evaluations. [from introduction]

Assessment of Early Diagnosis and Treatment of Malaria by Village Health Volunteers in the Lao PDR

This article assesses the effectiveness of village health volunteers in performing early diagnosis and treatment to reduce the burden of malaria in Loa PDR. [adapted from abstract]

Primary Health Care for Remote Village Communities in Honduras: a Model for Training and Support of Community Health Workers

This article presents a model for the development of sustainable primary health care in village communities in Honduras through the training and support of community health workers. [from author]

Realist Synthesis of Randomised Control Trials Involving Use of Community Health Workers for Delivering Child Health Interventions in Low and Middle Income Countries

This study examined evidence from randomized control trials on community health worker interventions in management of childhood illnesses from a realist perspective to gain insight into how these interventions work. [adapted from abstract]

Improving Health through Postpartum Home Visits, Family Planning Counseling: Scaling-Up Best Practices in Egypt

This paper shows how the Extending Service Delivery improve maternal and newborn health in Egypt’s Kaliobia Governorate by scaling-up the government’s postpartum care package in 13 villages, and training community health workers and nurses to put the package into practice. [from author]

Community Health Workers: Key Messages

This brief is a summary of the key messages from the Global Consultation on Community Health Workers in April 2010. It discusses planning, production and deployment; attraction and retention; and performance management as it relates to community health workers. [adapted from author]

Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals: A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems

With the overall aim of identifying community health worker (CHW) programs with positive impact on Millennium Development Goals (MDGs) related to health or otherwise, this global systematic review was undertaken of such interventions, as well as eight in-depth country case studies in Sub-Saharan Africa (Ethiopia Mozambique and Uganda), South East Asia (Bangladesh, Pakistan and Thailand) and Latin America (Brazil and Haiti).

Impact Evaluation of a Young Medical Volunteers Project for Vietnam Rural Mountain

This study evaluates the health impacts of a volunteer intervention addressing health worker shortage in remote mountainous communities of Vietnam. [from abstract]

Are Village Doctors in Bangladesh a Curse or a Blessing?

This paper investigates the role of various healthcare providers in provision of health services in a remote rural area in Bangladesh. [from abstract]

Community Acceptability of Use of Rapid Diagnostic Tests for Malaria by Community Health Workers in Uganda

This study assessed community acceptability of the use of rapid diagnostic tests by Ugandan community health workers, locally referred to as community medicine distributors. [from abstract]

Factors Affecting Recruitment and Retention of Community Health Workers in a Newborn Care Intervention in Bangladesh

This article investigated the reasons for the high rates of community health worker attrition in Bangladesh. [adapted from abstract]

Community Case Management Improves Use of Treatment for Childhood Diarrhea, Malaria and Pneumonia in a Remote District of Ethiopia

Ethiopia’s health extension workers (HEW) deliver preventive interventions and treat childhood diarrhea and malaria, but not pneumonia. Most of Ethiopia’s annual estimated 4 million childhood pneumonia cases go untreated. The purpose of this study was to evaluate the performance of volunteers in providing community case management for diarrhea, fever and pneumonia in a pre-HEW setting in Ethipia. [adapted from abstract]

Supervision of Community Peer Counsellors for Infant Feeding in South Africa: an Exploratory Qualitative Study

This qualitative paper reports on the experience of three community health worker (CHW) supervisors who were responsible for supporting infant feeding peer counsellors. The findings highlight the complexities of supervising and supporting CHWs. [adapted from abstract]

Revitalizing Primary Health Care: the Role of Lay Health Workers

Lay or community workers can be a valuable resource in response to the human resource crisis in many low- and middle-income countries. Successful interventions by lay health workers have led to improvements in maternal and child health, including reductions in mortality and morbidity from common childhood illnesses, and effective support to people receiving treatment for tuberculosis. [from author]

Validation of Community Health Workers' Assessment of Neonatal Illness in Rural Bangladesh

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

Malawi: Distribution of DMPA at the Community Level: Lessons Learned

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

Cost and Cost-Effectiveness of Smear-Positive Tuberculosis Treatment by Health Extension Workers in Southern Ethiopia: A Community Randomized Trial

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

Outcomes of Community Health Worker Interventions

The objective of this document was to conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. [from abstract]

Role of Community Health Workers in Improving Child Health Programmes in Mali

In rural settings, the promotion of household and community health practices through community health workers (CHWs) is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child health services in rural Mali. [from abstract]

Community-Based Distribution of Injectable Contraceptives in Malawi

This report presents research findings on the potential for making contraceptives, and in particular injectable contraceptives, widely available through using a community-based distribution approach which would expand the cadre of providers authorized to provide contraceptives to include health surveillance assistants and community-based distribution agents. [adapted from summary]

Are Vaccination Programmes Delivered by Lay Health Workers Cost-Effective? A Systematic Review

This paper reviews the costs and cost-effectiveness of vaccination programme interventions involving lay or community health workers. [from abstract]

Community Care Worker Management Policy Framework 2009

This draft policy framework is intended to provide an effective and efficient occupational workforce to support a comprehensive multidisciplinary health care service; strengthen partnerships between government, civil society and communities to consolidate, manage and focus the services offered by Community Care Workers; and delineate strategies that address systemic change within the complex systems both within the public sector and its partners. [from introduction]