{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.

The chart above shows the good-news-bad-news scenario that is the decades-long fight against TB in Afghanistan. TB is still a crushing problem there; the country has among the world’s highest rates of the disease, which killed some 10,000 people in 2017. But if you glance at this chart and think that we haven’t made much progress, look again. We’re finding and treating more people with TB in Afghanistan than ever before. In 2001, we were missing three quarters of presumptive TB patients — that is a whopping 75% gap in case detection.

{Nurse Gabriella Oroma welcomes patients at Ngetta Health Centre in Uganda, where drug-resistant TB is treated. Photo credit: Sarah Lagot/MSH}Nurse Gabriella Oroma welcomes patients at Ngetta Health Centre in Uganda, where drug-resistant TB is treated. Photo credit: Sarah Lagot/MSH
By Dr. Ersin Topcuoglu
 
This op-ed was originally published in The Hill.
 
 {Photo credit: Igor Dashevskiy}Deputy Minister of Health, Dr Roman Illyk, presents during the National Health Technology Assessment Forum in Kyiv, Ukraine.Photo credit: Igor Dashevskiy

A health technology assessment (HTA) is an evidence-based instrument to identify which medicines, medical devices, and treatment regimens are optimal for the state to support. It significantly reduces opportunities for corruption and helps countries move toward self-reliance in the health sector. A National Health Technology Assessment Forum took place in Kyiv, Ukraine, on February 28, 2019, to further advance HTA as an important priority-setting tool for Ukraine’s health system. Photo credit: Igor Dashevskiy

Afghanistan

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