scholarly journals Strategic partnering to improve community health worker programming and performance: features of a community-health system integrated approach

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Joseph F. Naimoli ◽  
Henry B. Perry ◽  
John W. Townsend ◽  
Diana E. Frymus ◽  
James A. McCaffery
Keyword(s):  
Health System ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Integrated Approach ◽  
Strategic Partnering ◽  
And Performance ◽  
Improve Community Health

Factors Impacting Sustainability of Community Health Worker Programming in rural Uganda: A Qualitative Study

2020 ◽  
Author(s):  
Scholastic Ashaba ◽  
Manasseh Tumuhimbise ◽  
Esther Beebwa ◽  
Francis Oriokot ◽  
Jennifer L Brenner ◽  
...  
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Community Health ◽  
Health Worker ◽  
Child Mortality ◽  
Community Health Worker ◽  
Sub Saharan Africa ◽  
Team Approach ◽  
Sub Saharan ◽  
And Training

Abstract Background Despite significant global progress towards decreased child mortality over the past decades, over 5 million children died before reaching their fifth birthday in 2018. Additionally, the number of women dying during pregnancy and childbirth was 295, 000 in 2017. Majority of these deaths occurred in sub Saharan Africa yet these deaths are preventable with known interventions. A huge global investment has been made in initiating community health work (CHW) programs which play a critical role in health promotion with increasing scale up in sub Saharan Africa. The government of Uganda continues to identify maternal, newborn and child health (MNCH) programming as a priority and national policies continue to encourage community-based approaches for health promotion through the Village Health Team approach to reduce maternal and child mortality. However, sustaining of CHWs programs remains a challenge and less is known about if and how these CHW networks can be maintained. Methods A sustainability-focused qualitative evaluation was conducted five years following a district-wide comprehensive MNCH intervention that involved selection and training of a large CHW network (n =2626) in 2 rural districts in southwest Uganda. Focus Group discussions (FGDs) and in-depth interviews (IDIs) were conducted to gain insights into the factors affecting CHW program sustainability. Interviews were digitally recorded then translated and transcribed directly into English. Data was managed using NVivo software (version 12, QSR International, Burlington Mass.). Thematic content analysis was done to identify themes relevant to sustainability. Results Enablers and barriers to CHW sustainability identified by study participants included health system effectiveness (availability of supplies, medicines and services and availability of facility health providers), community health worker program factors (CHW selection and training, CHW recognition and incentives, CHW supervision and CHW refresher trainings), community attitudes and beliefs, and stakeholder engagement (alignment with district priorities and programs and local government involvement). Conclusion Effectiveness of health systems and human resources were major factors in sustainability for this community health intervention. Sustainability could be strengthened through increased community member involvement during implementation and improved support for general health system effective functioning.

Using Job Analysis Techniques to Understand Training Needs for Promotores de Salud

2018 ◽  
Vol 20 (3) ◽  
pp. 455-465
Author(s):  
Javier H. Ospina ◽  
Toshiko A. Langford ◽  
Kimberly L. Henry ◽  
Tristan Q. Nelson
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Evaluation System ◽  
Job Training ◽  
Personal Characteristics ◽  
Job Analysis ◽  
Planned Parenthood ◽  
Job Tasks ◽  
And Performance

Despite the value of community health worker programs, such as Promotores de Salud, for addressing health disparities in the Latino community, little consensus has been reached to formally define the unique roles and duties associated with the job, thereby creating unique job training challenges. Understanding the job tasks and worker attributes central to this work is a critical first step for developing the training and evaluation systems of promotores programs. Here, we present the process and findings of a job analysis conducted for promotores working for Planned Parenthood. We employed a systematic approach, the combination job analysis method, to define the job in terms of its work and worker requirements, identifying key job tasks, as well as the worker attributes necessary to effectively perform them. Our results suggest that the promotores’ job encompasses a broad range of activities and requires an equally broad range of personal characteristics to perform. These results played an important role in the development of our training and evaluation protocols. In this article, we introduce the technique of job analysis, provide an overview of the results from our own application of this technique, and discuss how these findings can be used to inform a training and performance evaluation system. This article provides a template for other organizations implementing similar community health worker programs and illustrates the value of conducting a job analysis for clarifying job roles, developing and evaluating job training materials, and selecting qualified job candidates.

scholarly journals Governance of community health worker programs in a decentralized health system: a qualitative study in the Philippines

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Warren Dodd ◽  
Amy Kipp ◽  
Bethany Nicholson ◽  
Lincoln Leehang Lau ◽  
Matthew Little ◽  
...  
Keyword(s):  
Health System ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Local Governments ◽  
Local Politics ◽  
The Philippines ◽  
Health Needs ◽  
Health Priorities ◽  
Local Health

Abstract Background Community health worker (CHW) programs are an important resource in the implementation of universal health coverage (UHC) in many low- and middle-income countries (LMICs). However, in countries with decentralized health systems like the Philippines, the quality and effectiveness of CHW programs may differ across settings due to variations in resource allocation and local politics. In the context of health system decentralization and the push toward UHC in the Philippines, the objective of this study was to explore how the experiences of CHWs across different settings were shaped by the governance and administration of CHW programs. Methods We conducted 85 semi-structured interviews with CHWs (n = 74) and CHW administrators (n = 11) in six cities across two provinces (Negros Occidental and Negros Oriental) in the Philippines. Thematic analysis was used to analyze the qualitative data with specific attention to how the experiences of participants differed within and across geographic settings. Results Health system decentralization contributed to a number of variations across settings including differences in the quality of human resources and the amount of financial resources allocated to CHW programs. In addition, the quality and provider of CHW training differed across settings, with implications for the capacity of CHWs to address specific health needs in their community. Local politics influenced the governance of CHW programs, with CHWs often feeling pressure to align themselves politically with local leaders in order to maintain their employment. Conclusions The functioning of CHW programs can be challenged by health system decentralization through the uneven operationalization of national health priorities at the local level. Building capacity within local governments to adequately resource CHWs and CHW programs will enhance the potential of these programs to act as a bridge between the local health needs of communities and the public health system.

scholarly journals An integrated approach of community health worker support for HIV/AIDS and TB care in Angónia district, Mozambique

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Sandrine Simon ◽  
Kathryn Chu ◽  
Marthe Frieden ◽  
Baltazar Candrinho ◽  
Nathan Ford ◽  
...  
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Integrated Approach ◽  
Worker Support ◽  
Hiv Aids

scholarly journals The Governance of National Community Health Worker Programmes in Low- and Middle-Income Countries: An Empirically Based Framework of Governance Principles, Purposes and Tasks

2018 ◽  
Vol 8 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Helen Schneider
Keyword(s):  
Health System ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Political Support ◽  
Community Based ◽  
Middle Income ◽  
National Community ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: National community health worker (CHW) programmes are increasingly regarded as an integral component of primary healthcare (PHC) in low- and middle-income countries (LMICs). At the interface of the formal health system and communities, CHW programmes evolve in context specific ways, with unique cadres and a variety of vertical and horizontal relationships. These programmes need to be appropriately governed if they are to succeed, yet there is little evidence or guidance on what this entails in practice. Based on empirical observations of South Africa’s community-based health sector and informed by theoretical insights on governance, this paper proposes a practical framework for the design and strengthening of CHW programme governance at scale. Methods: Conceptually, the framework is based on multi-level governance thinking, that is, the distributed, negotiated and iterative nature of decision-making, and the rules, processes and relationships that support this in health systems. The specific purposes and tasks of CHW programme governance outlined in the framework draw from observations and published case study research on the formulation and early implementation of the Ward Based Outreach Team strategy in South Africa. Results: The framework is presented as a set of principles and a matrix of 5 key governance purposes (or outputs). These purposes are: a negotiated fit between policy mandates and evidence, histories and strategies of community-based services; local organisational and accountability relationships that provide community-based actors with sufficient autonomy and power to act; aligned and integrated programme management systems; processes that enable system learning, adaptation and change; and sustained political support. These purposes are further elaborated into 17 specific tasks, distributed across levels of the health system (national, regional, and local). Conclusion: In systematising the governance functions in CHW programmes, the paper seeks to shed light on how best to support and strengthen these functions at scale.

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