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Community Care Worker Management Policy Framework 2009

This draft policy framework is intended to provide an effective and efficient occupational workforce to support a comprehensive multidisciplinary health care service; strengthen partnerships between government, civil society and communities to consolidate, manage and focus the services offered by Community Care Workers; and delineate strategies that address systemic change within the complex systems both within the public sector and its partners. [from introduction]

Integrated Approach of Community Health Worker Support for HIV/AIDS and TB Care in Angonia District, Mozambique

This paper provides a participant-observer perspective of the evolution of community health workers from vertical and isolated activities for TB, HIV and other specific diseases to an integrated community health team approach for tackling the main disease burden in a rural district of Mozambique. [from introduction]

Evaluating the Impact of Community Based Health Interventions: Evidence from Brazil's Family Health Program

The goal of this paper is twofold. It uses the recent experience of Brazil’s Family Health Program to assess the effectiveness of community based health interventions as instruments for improvements in health conditions in less developed areas. It also evaluates whether the health improvements associated with the program also brought about the changes in household behavior predicted by economic theory and noticed in other contexts. [adapted from author]

Community-Based Health Workers Can Safely and Effectively Administer Injectable Contraceptives

Because of increased demand for injectable contraception coupled with an overburdened clinical health system, countries, particularly in sub-Saharan Africa, have recently expanded the use of non-clinic based approaches in providing this method. In this first review of the available evidence of these efforts, this consultation concluded that there is sufficient evidence to support expansion of community-based health workers providing progestin-only injectable contraceptives, especially DMPA. [from author]

Retention of Community Service Officers for an Additional Year at District Hospitals in KwaZulu-Natal and the Eastern Cape and Limpopo Provinces

This study sought to gain understanding of the motivations of community service (CS) officers to continue working at the same district hospital for a subsequent year after their obligatory year was over. The objectives were to determine the number of CS officers who actually remained at the same district hospital after completing their CS in 2002, the major factors that influenced them to remain and factors that would encourage the 2003 cohort of CS officers to remain at the same district hospital for an additional year. [from abstract]

Community-Based Care of Stroke Patients in a Rural African Setting

This article describes an attempt at developing a community-based model of stroke care based on the discharge planning of stroke patients, available resources and continuity of care between hospital and community in a remote rural setting in South Africa. [adapted from introduction]

Unpaid Community Volunteers - Effective Providers of Directly Observed Therapy (DOT) in Rural South Africa

This article reports on the obstacles to care and the outcome of treatment for patients presenting with tuberculosis to four hospitals in the rural South African region of Sekhukhuneland. [adapted from article]

Knowledge and Communication Needs Assessment of Community Health Workers in a Developing Country: a Qualitative Study

We conducted this study to document the perceptions of community health workers in Pakistan on their knowledge and communication needs, image building through mass media and mechanisms for continued education. [adapted from abstract]

Community Health Workers in South Africa: Where in This Maze Do We Find Ourselves?

This article offers an analysis of the role community health worker programs and activities in South Africa. [adapted from introduction]

Community Health Workers and Home-Based Care Programs for HIV Clients

This paper discusses the role and impact of community health workers in Nyanza Province, Kenya, in response to the growing demands the HIV epidemic has placed on the people and communities in this region. [adapted from abstract]

Community Defined Quality (CDQ): Creating Partnerships for Improving Quality

This presentation outlines a methodology to improve quality and accessibility of health care with greater involvement of the community in defining, implementing and monitoring the quality improvement process.

Task-Shifting HIV Counseling and Testing Services in Zambia: the Role of Lay Counselors

The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. [from abstract]

Systematic Review of Effect of Community-Level Interventions to Reduce Maternal Mortality

The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality. Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. [from abstract]

Hearing Community Voices: Grassroots Perceptions of an Intervention to Support Health Volunteers in South Africa

With the scarcity of African health professionals, volunteers are earmarked for an increased role in HIV/AIDS management, with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS - as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. [from abstract]

Community Health Workers for ART in Sub-Saharan Africa: Learning from Experience - Capitalizing on New Opportunities

Currently, a wide variety of community health workers are active in many antiretroviral treatment delivery sites. This article investigates whether present community health worker programmes for antiretroviral treatment are taking into account the lessons learnt from past experiences with community health worker programmes in primary health care and to what extent they are seizing the new antiretroviral treatment-specific opportunities. [from abstract]

Perceptions of Short-Term Medical Volunteer Work: a Qualitative Study in Guatemala

The issue of participation by medical providers from wealthy countries in short-term medical volunteer work in resource-poor countries has been reaised as being potentially harmful to recipient communities. This exploratory study examines the perception of short-term medical volunteer work in Guatemala from the perspective of members of recipient communities affected by or participating in these programs. [adapted from sbstract]

Community Health Workers: Ethiopia

This document provides resources on Ethiopia’s experiences with community health worker programs. [from abstract]

Assessment of the Training of the First Intake of Health Extension Workers

Ethiopia’s poor health status is due primarily to communicable diseases, poor nutrition, and lack of access to health services in general and for most of the rural, nomadic pastoralist and fringe areas in particular. In response, the government has launched a Health Extension Program for which training of Health Extension Workers has been started. This study assesses the first year’s training program in terms of its inputs, processes and output. [from abstract]

Analytical Report on Female Community Health Volunteers of Selected Districts of Nepal

Female Community Health Volunteers (FCHVs) act as a bridge between the government and the community and serve as a frontline for local health resources. The objectives of this study of FCHV in Twenty Districts of Nepal was to see the existing condition of the FCHVs working in the communities of Nepal. The survey collected information on basic health services provided by FCHVs to the community in terms of the provision of specific commodities and the provision of information, communication, counseling, and other support to the rural community. [adapted from summary]

Rethinking the Role of Community Health Workers

The shortage of health staff in developing countries has led to renewed interest in community-based health care workers. However, poor populations are increasingly accessing health services from a wide variety of providers operating as private or semi-private agents in unregulated markets. In this environment, is there a role for the community health worker? [from author]

China's Barefoot Doctor: Past, Present and Future

This document discusses China’s long struggle with rural coverage for health care through the barefoot doctors program, which was introduced as a national policy focused on quickly training paramedics to meet rural needs. [adapted from author]

Accelerating Reproductive and Child Health Program Impact with Community-Based Services: the Navrongo Experiment in Ghana

This report concludes that assigning nurses to community locations where they provide basic curative and preventive care substantially reduces childhood mortality and accelerates progress towards attainment of the child survival MDG. The research in Navrongo demonstrates that affordable and sustainable means of combining nurse services with volunteer action can accelerate attainment of both the International Conference on Population and Development agenda and the MDGs. [from summary]

Implementing a Community-Based Tuberculosis Program in the Omaheke Region of Namibia: Nurses' Perceived Challenges

The purpose of this survey was to identify nurses' perceived challenges in implementing a community-based TB program in the Omaheke region of Namibia. The HIV pandemic has increased the number of TB patients and increased nurses' workloads, aggravating the burden of TB as a resurgent disease in this region. In order to implement a successful community-based TB program, the patient-related, access-related and knowledge-related challenges, perceived by the nurses, need to be addressed effectively. [from abstract]

Role of Community-Based Surveillance in Health Outcomes Measurement

A community health planning and service strategy was started in Ashanti region in 2001 with the intention of improving geographic access to comprehensive health care. The region used community-based surveillance as an entry point. The implementation process and health outcomes were tracked and evaluated after a year. [from summary]

Lay Workers in Directly Observed Treatement (DOT) Programmes for Tuberculosis in High Burden Settings: Should They Be Paid? A Review of Behavioural Perspectives

The current global tuberculosis (TB) epidemic has pressured health care managers, particularly in developing countries, to seek for alternative, innovative ways of delivering effective treatment to the large number of TB patients diagnosed annually. One strategy employed is direct observation of treatment for all patients. In high-burden settings innovation with this strategy has resulted into the use of lay community members to supervise TB patients during the duration of anti-TB treatment.

Improving Community Health Worker Use of Malaria Rapid Diagnostic Tests in Zambia: Package Instructions, Job Aid and Job Aid-Plus-Training

Increased interest in parasite-based malaria diagnosis has led to increased use of rapid diagnostic tests (RDTs), particularly in rural settings. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. Use of RDTs by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. [adapted from introduction]

Community-Based Newborn Care: Are We There Yet?

The evidence base for strategies and interventions for newborn care in community settings has substantially improved, with a range of interventions that can be potentially packaged for delivery at different times during pregnancy, childbirth, and after birth, through various health-care providers. More recently, efficacy trials in representative rural settings have added to the evidence base. Such studies used innovative approaches with community health workers and varied preventive and treatment interventions. [from author]

12 Steps for Creating a Culture of Retention: a Workbook for Home and Community-Based Long-Term Care Providers

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

Guidelines for Practitioners of Community-Based Worker Systems

The purpose of these guidelines is to assist practitioners and implementing partners to run Community-Based Worker (CBW) systems more effectively, maximising impacts for clients of the service, empowering communities, empowering the CBWs themselves, and assisting governments to ensure that services are provided at scale to enhance livelihoods. The guidelines focus on how to run the CBW system rather than technicalities around HIV/AIDS or natural resources issues. [from introduction]