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.

Authors’ Commentary: Domestic Violence Against Women, Public Policies and Community Health Workers in Brazilian Primary Health Care

2019 ◽  
Vol 40 (3) ◽  
pp. 237-239
Author(s):  
Marcos Signorelli ◽  
Angela Taft ◽  
Pedro Paulo Gomes Pereira
Keyword(s):  
Health Care ◽  
Domestic Violence ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Professionals ◽  
Health Workers ◽  
Family Health ◽  
Further Education ◽  
Primary Health

In this commentary paper, we highlight the key role that community health workers and family health professionals can perform for the identification and care for women experiencing domestic violence in communities. These workers are part of the primary health-care strategy in the Brazilian public health system, who are available in every municipalities and neighborhoods of the country. Based on our ethnographic research, we argue that identification and care of abused women by these workers and professionals follow a pattern which we described and named “the Chinese whispers model.” We also point gaps in training these workers to deal with complex issues, such as domestic violence, arguing for the need of formal qualification for both community health workers and family health professionals by, for example, incorporating such themes into curricula, further education, and continuing professional development.

Validity of Questionnaires Administered by Community Health Workers and Auxiliary Nurses for Psychiatric Screening in Primary Health Care in Brazil

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J.M. Azevedo-Marques ◽  
A.W. Zuardi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Consultant Psychiatrist ◽  
Primary Health ◽  
Auxiliary Nurses ◽  
Total Accuracy ◽  
Psychiatric Screening

Aims:To evaluate the validity of three questionnaires used by community health workers and auxiliary nurses for psychiatric screening in primary health care (PHC) in Brazil.Method:Training for administrating the SRQ-20, WHO-5 and COOP/WONCA Charts was given by a consultant psychiatrist to community lay workers and auxiliary nurses working in four PHC teams in university community health center. The questionnaires (administered by 14 community lay workers and auxiliary nurses) and a semi-structured psychiatric interview (SCID - administered by the consultant psychiatrist blind to the patients results on questionnaires) were held with 120 PHC patients who were at least 15 years old. Predictive validities of SRQ-20, WHO-5 and individual items of COOP/ WONCA charts in relation to SCID were calculated through area under ROC curves (AUC) and total accuracy. Concurrent validities between questionnaires were calculated through spearman coefficients.Results:For SRQ-20 (20 questions): AUC = 0.92; total accuracy on cut-off 7/8 = 85%. For WHO-5 (5 questions): AUC = 0.90; total accuracy on cut-off 11/10 = 85%. For COOP/WONCA chart “feelings”: AUC = 0.88; total accuracy on cut-off 2/3 = 85%. Sperman coefficients between SRQ and COOP/WONCA chart “feelings” was 0.74; between WHO and “feelings” was 0.67.Conclusions:Results of COOP/WONCA Chart “feelings” - an individual item of a questionnaire specifically developed for use in primary health care - were as good as more extensive questionnaires specifically developed for psychiatric screening purposes.

scholarly journals Contribution of community health workers to primary health care performance in Brazil

2020 ◽  
Vol 54 ◽  
pp. 143
Author(s):  
Alaneir de Fátima dos Santos ◽  
Hugo André da Rocha ◽  
Ângela Maria de Lourdes Dayrell de Lima ◽  
Daisy Maria Xavier de Abreu ◽  
Érica Araújo Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Scale Up ◽  
Health Care Facilities ◽  
Children's Health ◽  
Children’S Health ◽  
Primary Health

OBJECTIVE: To associate the strength of community health workers interventions with primary health care strategies for women’s and children’s health, diabetes, and hypertension. METHODS: This is a cross-sectional study assessing 29,778 family health teams working in primary health care in Brazil in 2014. The association between community health workers activity levels and primary health care facilities was analyzed using multiple logistic regression. RESULTS: We found higher levels of community health workers activities strongly associated with primary health care practices (OR = 6.88) for those activities targeting hypertension management, followed by children’s health (OR = 6.56), and women’s health (OR = 6.21). CONCLUSIONS: At a time when Brazil discusses whether community health workers should or should not remain in the same scale-up and skill level as they currently are, our results reinforce the importance of these workers for the care model advocated by the Brazilian Unified Health System.

scholarly journals Visualising Primary Health Care: World Health Organization Representations of Community Health Workers, 1970–89

2018 ◽  
Vol 62 (4) ◽  
pp. 401-424 ◽  
Author(s):  
Alexander Medcalf ◽  
João Nunes
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
World Health Organization ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
World Health ◽  
Primary Health ◽  
The World ◽  
Health Organization

For the World Health Organization (WHO), the 1978 Alma-Ata Declaration marked a move away from the disease-specific and technologically-focused programmes of the 1950s and 1960s towards a reimagined strategy to provide ‘Health for All by the Year 2000’. This new approach was centred on primary health care, a vision based on acceptable methods and appropriate technologies, devised in collaboration with communities and dependent on their full participation. Since 1948, the WHO had used mass communications strategies to publicise its initiatives and shape public attitudes, and the policy shift in the 1970s required a new visual strategy. In this context, community health workers (CHWs) played a central role as key visual identifiers of Health for All. This article examines a period of picturing and public information work on the part of the WHO regarding CHWs. It sets out to understand how the visual politics of the WHO changed to accommodate PHC as a new priority programme from the 1970s onwards. The argument tracks attempts to define CHWs and examines the techniques employed by the WHO during the 1970s and early 1980s to promote the concept to different audiences around the world. It then moves to explore how the process was evaluated, as well as the difficulties in procuring fresh imagery. Finally, the article traces these representations through the 1980s, when community approaches came under sustained pressure from external and internal factors and imagery took on the supplementary role of defending the concept.

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