Community Interventions

Engaging Communities for Increasing Immunisation Coverage: What Do We Know?

The scoping paper focuses primarily on interventions and policies that lie at the intersection of immunisation and community engagement approaches. [from abstract]

Identifying Approaches and Tools for Evaluating Community-Based Medical Education Programmes in Africa

This article outlines the process of identifying tools that, with modification, could assist in the evaluation of Community-Based Education programmes in participating Medical Education Partnership Initiative schools, funded by PEPFAR.

State of the Social Service Workforce 2015 Report: A Multi-Country Review

This report sheds light on key social service workforce data and trends in 2014, showcases innovative and effective workforce strengthening initiatives, and highlights the impact of a lack of data in this fairly new area
of focus. This first annual report is envisioned as a first step among many other global, regional, and national
efforts to better describe, depict, and analyze efforts to strengthen the social service workforce. [from executive summary]

Global Evidence on Inequities in Rural Health Protection: New Data on Rural Deficits in Health Coverage for 174 Countries

This paper presents global estimates on rural/urban disparities in access to health-care services. The report uses proxy indicators to assess key dimensions of coverage and access involving the core principles of universality and equity. Based on the results of the estimates, policy options are discussed to close the gaps in a multi-sectoral approach addressing issues and their root causes both within and beyond the health sector. [from abstract]

Supporting Close-to-Community Providers Through a Community Health System Approach: Case Examples from Ethiopia and Tanzania

Close-to-community (CTC) providers, including community health workers or volunteers or health extension workers, can be effective in promoting access to and utilization of health services. Tasks are often shifted to these providers with limited resources and support from CTC programmes or communities. Two cases are presented. [from abstract]

Primary Health Care Expectations and Reality in Bangladesh: A Sociological Analysis of the Selected Two Rural Areas

This research deals with the expectations and reality of primary health care in Bangladesh and focuses on different
Government and NGOs health care situation in rural areas. [from abstract]

The Role of Social Service Workforce Development in Care Reforms

This working paper explores the topic of social service workforce strengthening as it relates to child care reform. It is intended to be a useful resource for reform efforts and a practical and accessible overview for use by policy-makers, practitioners, and service providers in contexts that are either considering the implications of care reforms for their social service workforce or are already engaged in the process. The paper illustrates key issues by drawing on the experiences of Indonesia, Moldova, and Rwanda, three countries in the process of reform. [from

Using the Lives Saved Tool as Part of Evaluations of Community Case Management Programs

Integrated community case management (iCCM) has been recommended by the World Health Organization to reduce mortality among children in populations with limited access to facility–based health care providers. Although many countries have introduced iCCM, interpretation of the impact is difficult due to many other activities occurring in the community. This paper suggests a method for using the Lives Saved Tool to model the independent impact of iCCM on child mortality. [from abstract]

Modeling Potential Reduction of Child Mortality After National Scale-Up of Community-Based Treatment of Childhood Illnesses in Ethiopia

Since 2010, 28,000 female health extension workers (HEWs) received training and support to provide integrated community based case management (iCCM) of childhood pneumonia, diarrhea, malaria, and severe malnutrition in Ethiopia. We conducted a modeling exercise using two scenarios to project the potential reduction of the under five mortality rate due to the iCCM program in the four agrarian regions of Ethiopia. [from abstract]

National Scale-Up of Integrated Community Case Management in Rural Ethiopia: Implementation and Early Lessons Learned

In 2010, Ethiopia added pneumonia to diarrhea, malaria and severe acute malnutrition, targeted for treatment in the integrated community case management (iCCM) strategy. This article describes the national scale-up of iCCM implementation and early lessons learned. [from abstract]

The Role of the District Family Physician

District clinical specialist teams were formed in 2012. One member of the team is the family physician. The role of the district family physician is discussed and the case made for focusing on the organisational health of the medical teams practising family medicine within the district as an effective way to improve the quality of medical care delivered in the district. [from abstract]

Strengthening the Foundation for Sustainable Primary Health Care Services in Nigeria

The aim of this descriptive, interventional study is to highlight positive steps taken by governments to re-establish and revitalise PHC, especially by empowering communities, the challenges, and lessons learned as potentials for improvement of a universal, qualitative PHC system in Nigeria. [from abstract]

Health Seeking Behaviour and Challenges in Utilising Health Facilities in Wakiso District, Uganda

The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs.
This study will assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. [from abstract]

Multisectoral Responses to Gender-based Violence in Mozambique

The complex constellation of factors that underlie and reinforce gender-based violence (GBV) warrants a strong multi-level and multisectoral response. This technical brief explores Pathfinder’s experience pioneering a multisectoral approach to GBV prevention and response across two projects in Mozambique, and outlines key lessons learned and next steps. [from abstract]

Analysis of Health Sector Gender Equality and Social Inclusion Strategy 2009 of Nepal

The policy on gender equality and social inclusion (GESI) in health sector of Nepal is formulated in 2009 targeting toward poor, vulnerable, marginalized social and ethnic groups. Gender inequality and social discrimination are a social problem that affect on individual health finally. The main objective of this paper is to critically analysis and evaluates the Government’s strategy on health sector gender equality and social inclusion in Nepal. [from abstract]

Perceived Barriers to Accessing Specialized Medical Care in Rural Communities of Ontario: A Pilot Study

Rural residents seeking health care face barriers due to a shortage of healthcare professionals and the travel distance required to obtain medical services. A pilot study was conducted to examine rural residents’ ability to access specialized care. This quantitative pen and paper survey was implemented in two communities with similar health care infrastructure(Tweed, Ontario and Hensall, Ontario). [adapted from abstract]

Managing Quality in Community Health Care Services

Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality. [from introduction]

Community Health Nurses’ Learning Needs in Relation to the Canadian Community Health Nursing Standards of Practice: Results From a Canadian Survey

This paper examines Canadian CHNs learning needs in relation to the 2008 Canadian Community Health Nursing Standards of Practice (CCHN Standards). It answers: What are the learning needs of CHNs in Canada in relation to the CCHN Standards? What are differences in CHNs’ learning needs by: province and territory in Canada, work setting (home health, public health and other community health settings) and years of nursing practice? [from abstract]

Primary Care and Public Health Services Integration in Brazil’s Unified Health System

We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice. [from abstract]

Development of a Smartphone-Enabled Hypertension and Diabetes Management Package to Facilitate Evidence-Based Care Delivery in Primary Healthcare Facilities in India: A Formative Research to Inform Intervention Design

Hypertension and diabetes have become a major public health challenge in India. This research work aims to develop a feasible and scalable intervention for hypertension and diabetes, tailored to primary care settings in India. [from abstract]

Making the Post-MDG Global Health Goals Relevant for Highly Inequitable Societies: Findings From A Consultation with Marginalized Populations in Guatemala

Achieving health goals in a context of deep-rooted inequality and marginalization requires going beyond the simple expansion of health services and working with developing trusting relationships between health service providers and community members. Involving community members in decision-making processes that shape policies will contribute to a
larger process of community empowerment and democratization. [from abstract]

Utilization of Community-based Health Information Systems in Decision Making and Health Action in Nyalenda, Kisumu County, Kenya

The development of comprehensive community based health information systems is increasingly becoming important for measuring and improving the quality of health services. Many developing countries including Kenya have made efforts to strengthen their national health information systems to provide information
for decision-making in managing health care services. The purpose of this paper is to explore how data collected at the community level is utilised by various stakeholders within the community in order to produce actionable information for decision making. [from abstract]

Reclaiming Public Health Through Community-Based Monitoring: The Case of Maharashtra, India

Community-based monitoring and planning (CBMP) of health services in Maharashtra state, India represents an innovative participatory approach to improving accountability and healthcare delivery. This paper examines the successes and challenges of this process, discussing lessons learned and the potential for generalizing such initiatives to other sectors and regions. Maharashtra’s experiment could inform ‘communitization’ of health services in diverse contexts, as an alternative to
privatization and as a means to enhancing the ‘publicness’ of health services. [from summary]

Strengthening Health Centre Committees as a Vehicle for Social Participation in Health in East and Southern Africa

Social participation in health systems has been a consistent element of post-independence health policies in east and Southern African (ESA) countries and central to primary health care (PHC). The Regional Network for Equity in Health in east and southern Africa (EQUINET) 2007 Regional Equity analysis highlighted that social participation and power are key for equitable health systems, and for reclaiming and using resources for health. [from introduction]

“Nothing For Us Without Us”: Establishing a Tuberculosis-Free Africa Through Community Action

African community activists have long recognized the need to strengthen the voices of African advocates and civil
society working to improve health and wellbeing across the continent. With funding from the United States Agency for
International Development (USAID), PATH helped former tuberculosis (TB) patients from five African countries to
build on the previous efforts of their colleagues to create a strong core organization—the Africa Coalition on
Tuberculosis (ACT!)—and then expand ACT!

The Significance of Community Engagement in Strengthening Health Systems

The Ebola epidemic has highlighted the importance of bridging trust and building common goals between the health profession and the communities they serve. [from introduction]

Considerations for Linking South Africa’s Youth-Friendly Services to its Community Health Worker Programme

In this article, we open the debate on whether or not South Africa’s Youth-friendly Services (YFS) programmes should be linked to community health worker (CHW) programmes. Both are important in South Africa’s efforts to re-engineer primary healthcare in the country. This article presents the pros and cons of linking the two programmes by incorporating YFS into the current list of CHW competencies. Also, we explore the alternative of training specialist CHWs to deliver YFS. [from abstract]

The Value of Building Health Promotion Capacities within Communities: Evidence From A Maternal Health Intervention in Guinea

This article presents results from a study that explored the association between community capacity for maternal health promotion and women’s use of preventive and curative maternal health services. Implemented in the Republic of Guinea, the intervention aimed to build the capacity of community-level committees to heighten awareness about maternal health risks and to promote use of professional maternal health services throughout pregnancy and childbirth. Data were collected through a population-based survey. [from abstract]

Analytical Problems and Approaches Towards Improving the Utilization of Primary Health Care Services by the Rural Communities in Nigeria

This paper assesses some analytical problems and approaches towards improving the utilization of primary health care services by the rural communities in Nigeria. This article examines some cross cutting issues in [Primary Health Care] PHC and outlines approaches to improve the use of health services by rural people. [adapted from abstract]

Is the Alma Ata Vision of Comprehensive Primary Health Care Viable? Findings From an International Project

The 4-year (2007–2011) Revitalizing Health for All international research program supported 20 research teams located in 15 low- and middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC) initiatives at their local or national levels. Three different reviewers synthesized each final project report through qualitative analysis to gauge equity in access, community empowerment and participation, social and environmental health determinants. {adapted from abstract]