community health workers

{Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity} Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity

This article was originally published by Global Health Now.

Paid or volunteer?

Community health workers are on the frontlines in many countries—and vital to achieving universal health coverage. Yet the public health community has not reached a consensus on which model is the best.

Consensus is urgently needed, both at the global and country levels, to inform future policies and strategies for strengthening health systems and delivering on UHC.

Based on our experiences in rural Peru and Ethiopia, it’s not either-or. It’s both.

Full-time, paid CHWs form the backbone of family- and community-based services, but there aren’t enough to reach all families. We envision teams of government-paid, full-time CHWs providing comprehensive services to a given population, with a primary health center hub as the base of operations. Each CHW, in turn, would lead a team of part-time community health volunteers providing limited health education and referral services—such as maternal and newborn health, nutrition, hygiene, tuberculosis, malaria, and HIV/AIDS—to a small number of neighboring families.

 {Photo credit: Samy Rakotoniaina/MSH}Community Health Volunteer in a remote village of Tulear, Madagascar, giving instructions to a client on the use of pregnancy tests.Photo credit: Samy Rakotoniaina/MSH

How Countries Can Move toward Building Sustainable Community Health Programs

Universal health coverage (UHC) is increasingly recognized as the best way to achieve the Sustainable Development Goal targets on health. But with 400 million people lacking access to essential health services and a projected shortage of 18 million health workers, it will take unprecedented effort and funding. Community health workers (CHWs) could be an important part of the solution—but without effective investments and sound planning, we will fall short of achieving UHC.

 {Photo credit: Katy Doyle/MSH}A health worker in Togo counsels a woman on reproductive health.Photo credit: Katy Doyle/MSH

Many years ago I began my public health career in Ciudad Nezahualcoyotl, then a squatter settlement of 1.8 million people, bordering Mexico City in the State of Mexico. Lack of land and unaffordable rents forced poor migrants, streaming in from the country side in search of employment and a better life in the city, to settle in the surrounding peri-urban areas. This large municipality, with few paved streets, was difficult to navigate in the rainy season. During the dry season, the wind would kick up dust storms that made it hard to see a block ahead. Nezahualcoyotl means hungry coyote in the Nahuatl language  and too many families in Neza, as people sometimes called it, were poor and hungry.

{Photo credit: Todd Shapera, Rwanda}Photo credit: Todd Shapera, Rwanda

Rwanda is one of the "biggest success stories" of countries improving child survival since 2000, the BBC World News reported April 29, 2015, linking to a podcast on BBC's The Inquiry.  

Randy Wilson, Principal Technical Advisor, Management Sciences for Health (MSH), spoke with BBC The Inquiry's Helena Merriman about MSH's role supporting Rwanda's efforts, including training community health workers with RapidSMS to saves lives. Said Wilson:

We helped to introduce RapidSMS within the districts, training 45,000 community health workers, many of whom who had never touched a cell phone in their life.

Wilson continued: "If there's even the slightest evidence" of a health concern, RapidSMS "encourages the community health worker not only to refer, but also to accompany, the mother to a facility where they get proper care."

{Screenshot, BBC, April 29, 2015}Screenshot, BBC, April 29, 2015According to the BBC:

World Health Worker Week (April 6-10, 2015) is an opportunity to mobilize communities, partners, and policymakers in support of health workers in your community and around the world. It is a time to celebrate, raise awareness, and renew commitments to health workers having the training, supplies and support they need to do their jobs safely and effectively.

Meet some of the health worker heroes among us!

Muhamed Mulongo, acting district health officer, Uganda

[Dr. Muhamed Mulongo] {Photo credit: Cindy Shiner/MSH}Dr. Muhamed MulongoPhoto credit: Cindy Shiner/MSH

Muhamed Mulongo decided when he was a boy to become a doctor after accompanying his sister to the hospital in the middle of the night during difficult labor. The baby died.

I said to myself, 'I should be a doctor I think'.

Now he is the only surgical doctor in the eastern Ugandan district of Bulambuli.

You work here only when you love your job.

You always have to improvise. You have no choice -- you have to save people in the process.

{Photo: Mark Tuschman, Kenya}Photo: Mark Tuschman, Kenya

Not Beyond Us. This is the theme of World Cancer Day 2015. But how will we achieve it? Cancer can seem insurmountable. The global cancer burden is great. In 2012, 8.2 million people died from cancer-related causes—most of them in Africa, Asia, and Central and South America, which experiences more cases and more deaths than anywhere else: 60 percent of the 14 million new cancer cases annually and 70 percent of all cancer-related deaths occur in the developing world. The same countries bearing the brunt of the cancer burden have the fewest resources to tackle it.

Still we know and remind one another today, the 4th of February: We can and must stop vaccine-preventable cancers and reduce preventable cancer deaths. We must reduce the cancer inequities.

Cancer, you are not beyond us.  

Among women, cervical cancer is one of the deadliest -- and most easily preventable -- cancers.  Women in the developing world account for 85 percent of the 270,000 deaths every year.  Yet we know that effective prevention, treatment and care are possible.

[Photo credit: Jane Briggs/MSH}Photo credit: Jane Briggs/MSH

This post originally appeared on SIAPSProgram.org.

Accounting for more than one million under-five deaths each year, pneumonia is the leading killer of children under the age of five worldwide, claiming more lives than AIDS, malaria, and tuberculosis combined. This year’s World Pneumonia Day (WPD) theme is “universal access to pneumonia prevention and care”.  In commemoration of WPD, child health advocates are calling for pneumonia control through proven interventions that protect against, prevent, and treat pneumonia. Through our work in community case management (CCM) and expanding access to amoxicillin, the US Agency for International Development (USAID)-funded, MSH-led Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program uses a systems-strengthening approach to expand universal access to pneumonia prevention and care.

 {Photo credit: Ian Sliney/MSH.}"Let's prevent Ebola together" billboard in Liberia.Photo credit: Ian Sliney/MSH.

Management Sciences for Health (MSH) hosted an interactive, three-day, online seminar on the West African Ebola outbreak on LeaderNet.org, October 28-30, 2014. Edited summaries from seminar facilitators (MSH Global Technical Lead on Malaria and Communicable Diseases, A. Frederick Hartman, MD, MPH, Days One-Three, and co-authored by Independent Pandemic Planning Advisor, Lisa Stone, Day Two), appear below. You can access seminar archives, including resources for preparedness and response, by joining LeaderNet.org.

Day One (Oct. 28): Mobilizing community-based care

Many thanks to the 240 individuals from more than 50 countries who have signed on to participate in the LeaderNet Ebola seminar so far. I am very impressed with your interest and enthusiasm in discussing, and ultimately controlling, this massive Ebola outbreak.

{Photo credit: Mark Tuschman, Kenya.}Photo credit: Mark Tuschman, Kenya.

Today, September 26, is World Contraception Day. The Family Planning 2020 (FP 2020) Initiative says the vision for the day "is a world where every pregnancy is wanted. Its mission is to improve the awareness of contraception to enable young people to make informed decisions on their sexual and reproductive health." We share part two of our interview with Dr. Fabio Castaño, MSH’s global technical lead of family planning (FP) and reproductive health, in celebration of World Contraception Day. Join the conversation on social media with hashtag .

Read Choice: Part One

 {Photo credit: Brigid Boettler/MSH}A participant asks a question during the congressional briefing on saving women's & children's lives in fragile countries.Photo credit: Brigid Boettler/MSH

It can be easy to take healthcare workers for granted. For the majority of us living in the United States, you know that a trained doctor and nurse will see you when you need assistance; a lab technician will do your blood work; and a certified pharmacist will dispense your prescriptions. But imagine going into labor and not knowing if a midwife or doctor will be present? Or, if you need a medication and there is no pharmacy to provide it?

These are the challenges facing millions of people in low- and middle-income countries—and the problems are made worse for those living in rural areas and/or fragile states.

Training health workers

To address this ongoing challenge, MSH, with International Medical Corps and the Frontline Health Workers Coalition, organized a Congressional briefing with the Congressional Women’s Caucus on March 26: “Saving Women’s and Children’s Lives: Strengthening the Health Workforce in Fragile Countries.”

At the heart of the discussion was the acknowledgement that to save lives you must have a strong health system and a strong health workforce.

Pages

Subscribe to RSS - community health workers