Community Health Workers

Community Health Workers
Author: Haile Mariam Kahssay
Publisher:
Total Pages: 73
Release: 1998
Genre: Medical
ISBN: 9789241561907
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This book examines the present and future role of community health workers (CHW) as part of ongoing efforts to develop sustainable health systems and improve public health. Noting that many programs based on the use of community health workers have fallen short of initial expectations, the book draws on numerous evaluations conducted over the past three decades to identify problems, explore their roots, and propose concrete solutions. Information ranges from advice on the composition and functions of village health committees through a discussion of the effect of cost recovery programs on community participation, to the simple reminder that programs that were never correctly implemented should not be dismissed as ineffective. Throughout lessons learned from past experiences are discussed in terms of their relevance to market-oriented reforms that are currently changing the health sector. The analysis is presented according to three main groups of factors known to have an impact on the performance of CHW programs. Attitudes are considered in the first chapter, which aims to define the actions health authorities can take to improve the attitudes of health workers and communities towards each other. Proposals include changes in selection criteria, curricula, teaching methods, on-the-job training, and supervision. Ways to increase community participation are also discussed. Chapter two focuses on the management and structure of district health systems as an area where organizational reform could have a significant impact on the success of CHW programs. Three components of the district health system are given particular attention: health service structure, health management structure, and health development structure. Practical advice is given for improving the functions of village health committees securing community participation and involving traditional healers. The final chapter, on resources, considers the important issues of remuneration, planning and budgeting for programs, and mechanisms for securing financing from governments, communities, and the private sector. Experiences from Thailand and Jamaica are used to explore methods for assessing program costs. The book concludes with a call for continuing international commitment to the CHW concept and a discussion of the main challenges likely to confront programs in the future. .

Strengthening the Performance of Community Health Workers in Primary Health Care

Strengthening the Performance of Community Health Workers in Primary Health Care
Author: World Health Organization
Publisher:
Total Pages: 52
Release: 1989
Genre: Medical
ISBN:
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This document describes a study that investigated the reasons for the frequent failure of national health systems based on primary health care to make effective use of community health workers. The report assesses different national experiences in order to pinpoint weaknesses, trace key mistakes, and define corrective actions. The report opens with a brief historical overview of problems that have arisen in the use of community health workers and reasons for these problems. Noting that governments frequently fail to decide what community health workers are expected to achieve, the second section proposes an explicit definition of the place, role, and functions of community health workers within the context of a national health system. The report then identifies and explores eight weaknesses, ranging from policy and organizational errors that have built failure into the system to problems of poor selection, insufficient training, inadequate motivation, and lack of reward. Strategies to overcome each problem are proposed. Specific recommendations drawn from national experiences are also included. The final sections condense the contents into a series of conclusions and recommendations intended to guide the reshaping of national programs. Eight references and a 59-item reading list conclude the document. (KC)

Improving Health in the Community

Improving Health in the Community
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 497
Release: 1997-05-21
Genre: Medical
ISBN: 0309055342
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How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

Achieving Health for All

Achieving Health for All
Author: David Bishai
Publisher: JHU Press
Total Pages: 369
Release: 2020-09-15
Genre: Medical
ISBN: 1421438135
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How did seven low- and middle-income countries, inspired by the landmark Alma-Ata Declaration, dramatically improve citizen health by focusing on primary health care? The Alma-Ata Declaration of 1978 marked a potential turning point in global health, signaling a commitment to primary health care that could have improved the safety of air, food, water, roads, homes, and workplaces in all 180 countries that signed it. Unfortunately, progress in many countries stalled in the 1980s. The declaration was, however, embraced by a number of countries, where its implementation led to substantial improvement in citizen health. Achieving Health for All reveals how, inspired by Alma-Ata, the governments of seven countries executed comprehensive primary health care systems, deploying new cadres of community-based health workers to bring relevant services to ordinary households. Drawing on a set of narrative case studies from Bangladesh, Indonesia, Ethiopia, Nepal, Ghana, Sri Lanka, and Vietnam,the book explains how a primary health care focus succeeded in improving population health. The book also conclusively demonstrates that comprehensive, multisector, community-controlled, and population-level primary health care is a viable strategy that, against the odds, has led to sustainable, scalable good health at lower cost. Bringing together a group of experts to analyze the forty-year legacy of the Alma-Ata Declaration, Achieving Health for All is a fascinating look at the work needed to transform nations from places that make people sick to places where they stay healthy. An inspiring array of lessons learned along the way shows how readers can make policies that support the health of all people. Contributors: Onaopemipo Abiodun, Vinya Ariyaratne, John Koku Awoonor-Williams, Kedar Prasad Baral, Ayaga A. Bawah, Pedro Más Bermejo, Fred N. Binka, David Bishai, Carolina Cardona, Dennis Carlson, Chala Tesfaye Chekagn, Hoang Khanh Chi, Svea Closser, Luc Barrière Constantin, Zufan Abera Damtew, Marlou de Rouw, Nadia Diamond-Smith, Philip Forth, Mignote Solomon Haile, Nguyen Thanh Huong, Taufique Joarder, Alice Kuan, Seblewengel Lemma, Sasmira Matta, Ahmed Moen, Rituu B. Nanda, Frank K. Nyonator, Ferdous Arfina Osman, Claudia Pereira, Henry B. Perry, James F. Phillips, Meike Schleiff, Melissa Sherry, Rita Thapa, Kebede Worku

Disease Control Priorities in Developing Countries

Disease Control Priorities in Developing Countries
Author: Dean T. Jamison
Publisher: World Bank Publications
Total Pages: 1449
Release: 2006-04-02
Genre: Medical
ISBN: 0821361805
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Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.

Primary Health Care

Primary Health Care
Author: World Health Organization
Publisher:
Total Pages: 62
Release: 1978
Genre: Medical
ISBN:
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Recommendations and report outlining operational aspects, suggested national strategies; nonAboriginal material.

Health Professions Education

Health Professions Education
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 191
Release: 2003-07-01
Genre: Medical
ISBN: 030913319X
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The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Clearing the Global Health Fog

Clearing the Global Health Fog
Author: Rifat Atun
Publisher: World Bank Publications
Total Pages: 80
Release: 2009-03-26
Genre: Political Science
ISBN: 0821379364
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A longstanding debate on health system organization relates to the benefits of integrating programs that emphasize specific interventions into mainstream health systems to increase access and improve health outcomes. This debate has long been characterized by polarization of views and ideologies, with protagonists for and against integration arguing relative merits of each approach. Recently, the debate has been rekindled due to substantial rises in externally-funded programs for priority health, nutrition, and population (HNP) interventions and an increase in international efforts aimed at health system strengthening. However, all too frequently these arguments have not been based on hard evidence. In this book we present findings of a systematic review that explores a broad range of evidence on: (i) the extent and nature of integration of targeted health programs that emphasize specific interventions into critical health systems functions; (ii) how the integration or non-integration of health programs into critical health systems functions in different contexts have influenced program success; and (iii) how contextual factors have affected the extent to which these programs were integrated into critical health systems functions. The findings provide a new synthesis of evidence to inform the debate on health systems and targeted interventions. In practice a rich mix of solutions exists. While the discussion on the relative merits of integrating health interventions will no doubt continue, discussions should move away from the highly-reductionist approach that has polarized this debate.

Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program

Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 299
Release: 2020-06-22
Genre: Medical
ISBN: 0309672058
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Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.