Community Health Workers

This summary is based on an update of a Cochrane systematic review published in 2010. The summary focuses on the effects of lay health worker interventions in improving maternal and child health and tuberculosis outcomes. [from author]

This study aimed to evaluate the contribution of community health workers with a focus on identifying the critical elements of an enabling environment that can ensure they provide quality services in a manner that is sustainable for expanding the health workforce to scale up HIV services. [adapted from author]

This article provides key lessons learned from a large-scale community-based efficacy trial of a two-tiered system of community-based workers to deliver a package of essential maternal and newborn-care interventions and one of three umbilical cord-care regimens in Bangladesh.

This study used both qualitative and quantitative measures to evaluate the role of the communtiy health workers in enhancing the interface between primary health care oriented health services and households in responses to HIV
and AIDS. [from author]

Studies and field observations have found that community health workers (CHWs) can provide injectables safely and that community access to injectables attracts new contraceptive users. This guide is designed to assist the many health professionals and advocates who are interested in making injectable contraceptives more widely available, especially for women with little or no access to health facilities. The guide describes six steps that advocates can take to support policy change to permit CHWs to provide injectables. [from summary]

This 2:21 video introduces Ade Yanarsih’s work and challenges as a local health worker and community midwife in Kampung Cirendeng, Indonesia.

This 2:56 minute video is part of the Good Goes campaign and showcases the work of Felix Aguilar Ramirez, a community health worker in the Xachmochan village in Guatemala.

This report examines approaches for the community management of sick children, specifically antimicrobial treatment, through the use of community health workers or their equivalent. It is based on an extensive review of literature, including peer-reviewed studies, reports, programme descriptions and program evaluations. [from introduction]

This article assesses the effectiveness of village health volunteers in performing early diagnosis and treatment to reduce the burden of malaria in Loa PDR. [adapted from abstract]

This article presents a model for the development of sustainable primary health care in village communities in Honduras through the training and support of community health workers. [from author]

This study examined evidence from randomized control trials on community health worker interventions in management of childhood illnesses from a realist perspective to gain insight into how these interventions work. [adapted from abstract]

This paper shows how the Extending Service Delivery improve maternal and newborn health in Egypt’s Kaliobia Governorate by scaling-up the government’s postpartum care package in 13 villages, and training community health workers and nurses to put the package into practice. [from author]

This brief is a summary of the key messages from the Global Consultation on Community Health Workers in April 2010. It discusses planning, production and deployment; attraction and retention; and performance management as it relates to community health workers. [adapted from author]

With the overall aim of identifying community health worker (CHW) programs with positive impact on Millennium Development Goals (MDGs) related to health or otherwise, this global systematic review was undertaken of such interventions, as well as eight in-depth country case studies in Sub-Saharan Africa (Ethiopia Mozambique and Uganda), South East Asia (Bangladesh, Pakistan and Thailand) and Latin America (Brazil and Haiti).

This study evaluates the health impacts of a volunteer intervention addressing health worker shortage in remote mountainous communities of Vietnam. [from abstract]

This paper investigates the role of various healthcare providers in provision of health services in a remote rural area in Bangladesh. [from abstract]

This study assessed community acceptability of the use of rapid diagnostic tests by Ugandan community health workers, locally referred to as community medicine distributors. [from abstract]

This article investigated the reasons for the high rates of community health worker attrition in Bangladesh. [adapted from abstract]

Ethiopia’s health extension workers (HEW) deliver preventive interventions and treat childhood diarrhea and malaria, but not pneumonia. Most of Ethiopia’s annual estimated 4 million childhood pneumonia cases go untreated. The purpose of this study was to evaluate the performance of volunteers in providing community case management for diarrhea, fever and pneumonia in a pre-HEW setting in Ethipia. [adapted from abstract]

This qualitative paper reports on the experience of three community health worker (CHW) supervisors who were responsible for supporting infant feeding peer counsellors. The findings highlight the complexities of supervising and supporting CHWs. [adapted from abstract]

This report outlines a training program for health extension workers in long-acting family planning methods in Ethiopia.

Lay or community workers can be a valuable resource in response to the human resource crisis in many low- and middle-income countries. Successful interventions by lay health workers have led to improvements in maternal and child health, including reductions in mortality and morbidity from common childhood illnesses, and effective support to people receiving treatment for tuberculosis. [from author]

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

The objective of this document was to conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. [from abstract]

In rural settings, the promotion of household and community health practices through community health workers (CHWs) is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child health services in rural Mali. [from abstract]

This report presents research findings on the potential for making contraceptives, and in particular injectable contraceptives, widely available through using a community-based distribution approach which would expand the cadre of providers authorized to provide contraceptives to include health surveillance assistants and community-based distribution agents. [adapted from summary]

This paper reviews the costs and cost-effectiveness of vaccination programme interventions involving lay or community health workers. [from abstract]

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]