1 million community health workers in sub-Saharan Africa by 2015

Abstract

During the past 10 years, community health workers (CHWs) have emerged as a focal point of international discussions of primary health-care systems. Although lay community-based health workers have been active for at least 60 years, the Millennium Development Goals (MDGs) in 2000 prompted new discussion of how these workers can help to extend primary health care from facilities to communities. CHWs have since been part of an international attempt to revise primary health-care delivery in low-income settings, and CHW programmes have been changed accordingly. Instead of being regarded as unpaid, lightly trained members of the community who focus mainly on health education and provide basic treatments, CHWs are increasingly envisioned as a trained and paid corps who give advice and treatments, and implement preventive measures. Many national governments, including those of Brazil, Pakistan, Ethiopia, and India, 1 are making CHWs a cornerstone of the scaling up of community health delivery.A key diff erence between the old and new CHW models is that workers are now viewed as an integral and formal part of the health system, with reporting lines, training, supervision, and feedback. Several develop ments have stimulated eff orts to develop a more substantial role for CHWs in primary health care; new mobile health technologies, household-administered rapid diagnostic tests, and expert support systems based on information and communications technologies (ICTs) are greatly enlarging the range of services that CHWs can eff ectively provide. New ICTs are also enabling improved training and supervision methods, and make the eff ectiveness of evidence-based com munity-based protocols delivered by CHWs easier to measure and show. [2][3][4]

The future of health in Zimbabwe

“…Some innovative ways to strengthen the health workforce would be: (1) to encourage retention and motivation of current workers through better, safer work environments; (2) to build leadership capacity in the workforce, potentially by mobilizing the Zimbabwean health diaspora to engage in training and skill-building among the current workforce [3]; and (3) to place a greater reliance on mid-level and non-specialist providers [32] and on community members including community health workers (CHWs) [33–36] and traditional healers [37–40]. …”

“…This will mean hiring Zimbabweans, building capacity, and listening carefully to local priorities. Community health models, often using community health workers, have been successful in many areas of global health including HIV/AIDS, child health, malaria, and tuberculosis [33,35,36]. Although a village health worker program was installed in the 1980s via the Health Transition Fund, this effort was limited by a lack of true community participation and a bureaucratic top-down approach where decisions were still made by the Ministry of Health [2].…”

Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

“…The delivery was executed by "village doctors" who were lay community health workers, historically called "barefoot doctors" in China. Community health workers are playing increasingly important roles in low-income countries (Singh and Sachs, 2013). For illiterate women, local health workers explained the content in the pamphlet.…”

Why US Health Care Should Think Globally

“…As soaring costs increasingly threaten to make health care unaffordable, causing the greatest harm to the disenfranchised, the United States should look to systems that serve difficult-to-reach populations and deliver quality care-and do so efficiently. For example, community health workers have become integral to health care systems across sub-Saharan Africa and India, providing a model of low-cost care delivery [11]. And, in fact, US-based organizations that bridge hospital systems and their neighborhoods are beginning to implement community health worker models inspired by counterparts abroad [12].…”