scholarly journals Community health workers & medical students: a strategic partnership for Brazilian public health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Faria de Moura Villela ◽  
F Morato de Oliveira
Keyword(s):  
Public Health ◽  
Medical Students ◽  
Focus Groups ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Role Playing ◽  
Strategic Partnership ◽  
The Public

Abstract Introduction Family Health Strategy represents a successful initiative for reorganization of primary care in Brazil. A differential is the Community Health Workers (CHW), who act facilitating community access to effective professional care in the form of health-promoting actions. However, the way CHW receive training to manage epidemics, as dengue, is almost unknown. In this context, this project addresses the importance of bringing together medical students and CHW in order to strengthening not only continuing education of CHW, but also the experienced learning of future physicians. Methods An exploratory study of qualitative approach was done. Two focus groups were conducted with ten CHW in a primary health care unit (PHCU) in Brazilian Midwest. The focus groups were conducted by the tutor and students previously trained on dengue prevention and management. Results Students identified difficulties in daily work and informational/ communicational gaps based on what was said by CHW if compared with the Ministry of Health protocol towards dengue control. These gaps were the basis for an action strategy to develop with CHW. Students developed strategies based on knowledge acquired on public health and experienced practices in medical school: meetings with CHW and other health professionals using lectures, conversation circles, role-playing and problem-situations. All activities were previously prepared by students under supervision. After all, we held the second focus group with the same CHW to evaluate the impact of the strategies adopted. 60% said their routine is now more dynamic and effective, only 10% state that their routine remains difficult. 80% said that after the training meetings the manager of the PHCU invited them to participate more actively. Conclusions This project brought the students to the reality of CHW health practices, what is a great opportunity to increase their commitment with the local health system and social accountability. Key messages The partnership between academy and health service is a challenge but when succeeded it enables changes in and may result in improvement processes in the public health system. The role of community health workers to achieve behavioral change in the community and to improve the public health of a country.

OA55 Impact of community health workers for continuum care of palliative care at community level integrated in rwanda public health system

2015 ◽  
Vol 5 (Suppl 1) ◽  
pp. A17.3-A17 ◽  
Author(s):  
Christian Ntizimira ◽  
Osee Sebatunzi ◽  
Olive Mukeshimana ◽  
Viviane Umutesi ◽  
Scholastique Ngizwenayo
Keyword(s):  
Public Health ◽  
Palliative Care ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Public Health System ◽  
Health Workers ◽  
Community Level

scholarly journals Community health workers in rural Punjab, India: analyzing their role, expectations and challenges

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Niharika Mahajan ◽  
Baljit Kaur
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Rural Community ◽  
Health Workers ◽  
Role Expectations ◽  
Public Hospitals ◽  
Content Type ◽  
The Public ◽  
Multistage Sampling

PurposeThis study aimed to analyze the role of community health workers (CHWs) called accredited social health activists (ASHAs) in improving maternal health outcomes in the rural community of Punjab, India. The study also examined the expectations of these workers from the community and identified the problems faced by them in carrying out their roles.Design/methodology/approachUsing multistage sampling, a total of 28 villages were selected from seven districts of Punjab, and from these selected villages, a total of 57 ASHAs working as the interface between the rural community and the public health system and 420 women who had delivered a baby were interviewed.FindingsDesire to earn money was the most prominent reason for joining the community work program, but ASHAs felt overburdened and underpaid compared to their work commitments. Not only was the incentive paid to these workers was insufficient and irregular but they also suffered at the hands of medical staff at public hospitals.Research limitations/implicationsThe study uses a demand side perspective, and the views of other stakeholders in the health system have not been considered.Social implicationsThe respective governments should acknowledge the indispensable contributions made by these CHWs without whom the dream of taking healthcare at the doorstep would have crumbled like popadums.Originality/valueWhile exploring the problems experienced by the CHWs, this study recommends opting for a mix of monetary and nonmonetary incentives for acknowledging the work of CHWs. The study is the first of its kind for the state of Punjab battling with a worsening maternal mortality rate (MMR).

scholarly journals An innovative approach to improve the detection and treatment of risk factors in poor urban settings: a feasibility study in Argentina

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Poggio Rosana ◽  
Goodarz Danaei ◽  
Laura Gutierrez ◽  
Ana Cavallo ◽  
María Victoria Lopez ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Primary Care ◽  
Community Health ◽  
Community Health Workers ◽  
Feasibility Study ◽  
Health Workers ◽  
Health Coverage ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Background The effective management of cardiovascular (CVD) prevention among the population with exclusive public health coverage in Argentina is low since less than 30% of the individuals with predicted 10-year CVD risk ≥10% attend a clinical visit for CVD risk factors control in the primary care clinics (PCCs). Methods We conducted a non-controlled feasibility study using a mixed methods approach to evaluate acceptability, adoption and fidelity of a multi-component intervention implemented in the public healthcare system. The eligibility criteria were having exclusive public health coverage, age ≥ 40 years, residence in the PCC’s catchment area and 10-year CVD risk ≥10%. The multi-component intervention addressed (1) system barriers through task shifting among the PCC’s staff, protected medical appointments slots and a new CVD form and (2) Provider barriers through training for primary care physicians and CHW and individual barriers through a home-based intervention delivered by community health workers (CHWs). Results A total of 185 participants were included in the study. Of the total number of eligible participants, 82.2% attended at least one clinical visit for risk factor control. Physicians intensified drug treatment in 77% of participants with BP ≥140/90 mmHg and 79.5% of participants with diabetes, increased the proportion of participants treated according to GCP from 21 to 32.6% in hypertensive participants, 7.4 to 33.3% in high CVD risk and 1.4 to 8.7% in very high CVD risk groups. Mean systolic and diastolic blood pressure were lower at the end of follow up (156.9 to 145.4 mmHg and 92.9 to 88.9 mmHg, respectively) and control of hypertension (BP < 140/90 mmHg) increased from 20.3 to 35.5%. Conclusion The proposed CHWs-led intervention was feasible and well accepted to improve the detection and treatment of risk factors in the poor population with exclusive public health coverage and with moderate or high CVD risk at the primary care setting in Argentina. Task sharing activities with CHWs did not only stimulate teamwork among PCC staff, but it also improved quality of care. This study showed that community health workers could have a more active role in the detection and clinical management of CVD risk factors in low-income communities.

scholarly journals Intimate Labor at Biomedical Frontlines: Situated Knowledges of Female Community Health Workers in the Management of COVID-19 in India

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sanghamitra Das ◽  
Samhita Das
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Medical Knowledge ◽  
Healthcare Services ◽  
Care Work ◽  
Professional Status ◽  
Public Healthcare ◽  
The Public ◽  
Female Community

Media reports of the COVID-19 pandemic in India have highlighted the important role that India’s female community health workers, the Accredited Social Health Activists (ASHAs), have played in managing COVID infections in India. This paper explores the epistemic basis of ASHA work to understand the significance of their role. Through a discourse analysis of textual media articles, we show that the ASHAs’ routine and COVID-related caregiving practices are a form of embodied, intimate labor rooted in their situated, community-oriented knowledge. This labor is devalued as emotional and feminized care work, which denies the ASHAs professional status in the public healthcare system of India and, in turn, reflects a hierarchy among health practitioners that stems from the status of objectivity/disembodiment in biomedicine. We find that, despite their low status in the public health system, ASHA workers develop a self-concept that enables them to self-identify as healthcare professionals, motivating them to continue providing essential healthcare services during the pandemic. We argue that an official recognition of the epistemic value of ASHA work would help to overcome the age-old nature/culture dichotomy that informs what counts as valuable, legitimate, formal medical knowledge. Furthermore, our analysis provides a critique of the gendered devaluation of care work within a political economy of health increasingly dictated by a neoliberal logic.

scholarly journals Design of Mobile Application for Community Health Workers: A Case Study in Rwanda

2020 ◽  
Vol 14 (11) ◽  
pp. 271
Author(s):  
Gahizi Emmanuel ◽  
Andi Wahju Rahardjo Emanuel ◽  
Djoko Budiyanto Setyohadi
Keyword(s):  
Public Health ◽  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Human Service ◽  
Mobile Application ◽  
Health Workers ◽  
User Centered Design ◽  
Public Health Services ◽  
Adequate Knowledge

Community health workers (CHWs) are the basis of public health services that aim to connect the gap between public health and the human service system. This gap can be completely bridged by navigating the health and human service systems and educating communities on disease prevention. Unfortunately, the way of sharing, accessing information, and delivering health services is still non-digitalized in Rwanda. Community Health workers use a manual system in their daily activities, which is prone to error and falsification. Moreover, these people selected to perform these activities often do not have adequate knowledge about diseases and health systems since they are not professional health workers. To address the above problem, we designed a prototype mobile application to enable these workers to automatically submit reports, transfer knowledge, share information, and receive training from professionals.  The design process followed a User-Centered Design approach to meet the users’ requirements. The evaluation of the design showed that 91.7% of the CHWs agreed with the designed application prototype.  This finding shows that CHWs has an interest in using the mobile application in their work. Using the mobile application will help CHWs to improve data collection, the reporting process, and ease of receiving training.

What are the roles of community health workers? Looking back at the philosophies of primary health care

2019 ◽  
Vol 27 (2) ◽  
pp. 117-120
Author(s):  
Marietou Niang
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Development ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Primary Health ◽  
Looking Back

This commentary discusses the different roles of community health workers (CHWs), their challenges and limitations in a historical perspective of primary health care (PHC). We first try to show that the comprehensive philosophy of PHC promulgated in Alma-Ata proposed the role of CHWs as actors who work in community development. On the other hand, in the 1980s, with the emergence of the selective philosophy of PHC, CHWs’ role was more affiliated with the health system. We conclude our pitch about the balance that can exist between these different roles by suggesting that CHWs can work in continuity with the health system, but they should not be considered as affordable labor. Also, they must be supported in their activities to develop their communities, allowing them to participate effectively in programs and policies that concern them and their community.

scholarly journals Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rhonda C. Boyd ◽  
Marjie Mogul ◽  
Deena Newman ◽  
James C. Coyne
Keyword(s):  
Mental Health ◽  
Postpartum Depression ◽  
Focus Groups ◽  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Academic Community ◽  
Barriers And Facilitators ◽  
Postpartum Women

Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1) screening and referral, (2) facilitators to referral, (3) barriers to referral, (4) culture and language, (5) life events, and (6) support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

scholarly journals Community health workers at the dawn of a new era: 9. CHWs’ relationships with the health system and communities

2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Karen LeBan ◽  
Maryse Kok ◽  
Henry B. Perry
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Large Scale ◽  
Health Workers ◽  
Local Level ◽  
Grey Literature ◽  
Community Context ◽  
New Era

Abstract Background This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major challenge in large-scale CHW programmes is the need for CHWs to establish and maintain beneficial relationships with both sets of actors, who may have different expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities. Methods The authors conducted a selective review of journal articles and the grey literature, including case study findings in the 2020 book Health for the People: National CHW Programs from Afghanistan to Zimbabwe. They also drew upon their experience working with CHW programmes. Results The space where CHWs form relationships with the health system and the community has various inherent strengths and tensions that can enable or constrain the quality of these relationships. Important elements are role clarity for all actors, working referral systems, and functioning supply chains. CHWs need good interpersonal communication skills, good community engagement skills, and the opportunity to participate in community-based organizations. Communities need to have a realistic understanding of the CHW programme, to be involved in a transparent process for selecting CHWs, and to have the opportunity to participate in the CHW programme. Support and interaction between CHWs and other health workers are essential, as is positive engagement with community members, groups, and leaders. Conclusion To be successful, large-scale CHW programmes need well-designed, effective support from the health system, productive interactions between CHWs and health system staff, and support and engagement of the community. This requires health sector leadership from national to local levels, support from local government, and partnerships with community organizations. Large-scale CHW programmes should be designed to enable local flexibility in adjusting to the local community context.

Health strike is unlikely to shape Kenya national vote

2017 ◽  
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Content Type ◽  
The Public ◽  
General Elections ◽  
Slow Progress ◽  
National Settlement

Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.

Global health's durable dreams: ethnography, ‘community health workers’ and health without health infrastructure

Africa ◽  
2020 ◽  
Vol 90 (1) ◽  
pp. 95-111
Author(s):  
Ramah McKay
Keyword(s):  
Public Health ◽  
Global Health ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Social Relations ◽  
Health Workers ◽  
Health Coverage ◽  
Global Health Policy ◽  
Public Health Officials

AbstractTracing the persistence of community health workers (CHWs) as a key category in both global health policy and anthropological representation, this article asks how enduring scholarly investments in CHWs can reveal changing political stakes for both health work and ethnographic research. Amid renewed calls for a focus on health systems and universal health coverage, the article suggests that the durability of attention to CHWs is instructive. It simultaneously points to the imbrication of health with political and social relations and clinical and technological infrastructures as well as to how ethnographic investments in health systems can sometimes obscure the ambivalent politics of health. Drawing on fieldwork with CHWs, NGO staff and public health officials, and on public health literature on CHWs, it argues for greater attention to the political ambivalence of health labour. It suggests that the experiences of health workers themselves can serve as analytical examples in this regard, pointing to analyses that begin not with normative notions of health systems or the conceptual boundaries of global health ‘projects’ but with a focus on the contested relations through which health labour is realized over time. Such attention can also indicate possibilities for health beyond dreams of projects, clinics or health systems.

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