A framework for identifying and learning from countries that demonstrated exemplary performance in improving health outcomes and systems

Carter, Austin; Akseer, Nadia; Ho, Kevin K.W.; Rothschild, Oliver; Bose, Niranjan; Binagwaho, Agnès; Hirschhorn, Lisa R.; Price, Matthew; Muther, Kyle; Panjabi, Raj; Freeman, Matthew C.; Bednarczyk, Robert A.; Bhutta, Zulfiqar A

doi:10.1136/bmjgh-2020-002938

Cited by 19 publications

(35 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We represent a range of stakeholders brought together through the EGH partnership, an initiative focused on identifying lessons learnt from positive outliers in global health and harnessing the expertise of programme leaders, researchers and funders to better understand what underpins health gains and implementation success. [5][6][7] As such, our perspectives may not be shared by others in RI programmes for a given context; further, they may not represent challenges and/or mitigation strategies occurring now.…”

Section: Summary Boxmentioning

confidence: 99%

Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia

et al. 2021

Self Cite

View full text Add to dashboard Cite

Section: Summary Boxmentioning

confidence: 99%

Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia

et al. 2021

Self Cite

View full text Add to dashboard Cite

“…Brazil is one of four countries selected by the Exemplars in Global Health Partnership because of the demonstrated exemplary performance of its CHW programmes, along with Bangladesh, Ethiopia, and Liberia [ 52 , 53 ]. Brazil’s CHW programme has been evolving since the early 1980s when it was first introduced as an emergency pilot project in one of the poorest areas of Brazil (Ceará) in the midst of a serious drought.…”

Section: Discussionmentioning

confidence: 99%

“…Liberia is another one of four countries selected by the Exemplars in Global Health Partnership because of the demonstrated exemplary performance of its CHW programmes, along with Bangladesh, Brazil, and Ethiopia [ 52 , 53 ]. Following a protracted civil war that ended in 1996 and the devastating Ebola outbreak in 2004–2015, the government of Liberia together with donor partners and civil society joined together to upgrade its poorly functioning and fragmented programme of volunteer CHWs by updating its National Community Health Services Policy and Strategic Plan, leading to the formation of a paid CHW cadre of community health assistants in communities more than 5 km from a health facility.…”

Section: Discussionmentioning

confidence: 99%

Community health workers at the dawn of a new era: 2. Planning, coordination, and partnerships

Afzal¹,

Pariyo

Lassi

et al. 2021

Health Res Policy Sys

View full text Add to dashboard Cite

Background Community health workers (CHWs) play a critical role in grassroots healthcare and are essential for achieving the health-related Sustainable Development Goals. While there is a critical shortage of essential health workers in low- and middle-income countries, WHO and international partners have reached a consensus on the need to expand and strengthen CHW programmes as a key element in achieving Universal Health Coverage (UHC). The COVID-19 pandemic has further revealed that emerging health challenges require quick local responses such as those utilizing CHWs. This is the second paper of our 11-paper supplement, “Community health workers at the dawn of a new era”. Our objective here is to highlight questions, challenges, and strategies for stakeholders to consider while planning the introduction, expansion, or strengthening of a large-scale CHW programme and the complex array of coordination and partnerships that need to be considered. Methods The authors draw on the outcomes of discussions during key consultations with various government leaders and experts from across policy, implementation, research, and development organizations in which the authors have engaged in the past decade. These include global consultations on CHWs and global forums on human resources for health (HRH) conferences between 2010 and 2014 (Montreux, Bangkok, Recife, Washington DC). They also build on the authors’ direct involvement with the Global Health Workforce Alliance. Results Weak health systems, poor planning, lack of coordination, and failed partnerships have produced lacklustre CHW programmes in countries. This paper highlights the three issues that are generally agreed as being critical to the long-term effectiveness of national CHW programmes—planning, coordination, and partnerships. Mechanisms are available in many countries such as the UHC2030 (formerly International Health Partnership), country coordinating mechanisms (CCMs), and those focusing on the health workforce such as the national Human Resources for Health Observatory and the Country Coordination and Facilitation (CCF) initiatives introduced by the Global Health Workforce Alliance. Conclusion It is imperative to integrate CHW initiatives into formal health systems. Multidimensional interventions and multisectoral partnerships are required to holistically address the challenges at national and local levels, thereby ensuring synergy among the actions of partners and stakeholders. In order to establish robust and institutionalized processes, coordination is required to provide a workable platform and conducive environment, engaging all partners and stakeholders to yield tangible results.

show abstract

“…For those countries that have achieved success it is often not understood or documented how success has been achieved. 10 Recent studies on “exemplars” in community health have started to unpack this “black box.” 11 …”

Section: Introductionmentioning

confidence: 99%

“…10 Recent studies on "exemplars" in community health have started to unpack this "black box." 11 In response to this challenge, the U.S. Agency for International Development (USAID), United Nations Children's Fund (UNICEF), and the Bill and Melinda Gates Foundation formed the Integrating Community Health Program (ICH), a collaboration 12 to advance community-based servicedelivery models in 7 countries: Bangladesh, Democratic Republic of the Congo, Haiti, Kenya, Liberia, Mali, and Uganda. ICH-supported partner organizations in each of these countries have worked with their respective ministries of health to scale, strengthen, or sustain community health programs.…”

mentioning

confidence: 99%

The Community Health Systems Reform Cycle: Strengthening the Integration of Community Health Worker Programs Through an Institutional Reform Perspective

Chen¹,

Raghavan²,

Albert³

et al. 2021

Glob Health Sci Pract

View full text Add to dashboard Cite

Despite strong interest and policy commitments from many countries, models for community-based primary health service delivery have been slow to achieve full scale or deliver quality that matches their potential. n Reform requires a carefully choreographed effort to enroll key stakeholders to support change by spotlighting a locally relevant gap in the existing health system's performance. n Designing and launching community health programs depends heavily on local context and must draw from models that are available within a given health system and that align with the resources, capabilities, and commitments of key stakeholders. n Reform should be viewed as an ongoing adaptive and evolutionary process; learning, governance, and management systems must be designed with this trajectory in mind. Key Implications Ministries of health, development partners, and other reform stakeholders can: n Use the principles in the reform cycle process to identify gaps and priorities for technical work or investment n Examine community health efforts to identify where technical approaches can be complemented by political, institutional, and reform approaches n Critically examine projects that implement termlimited, externally driven interventions and adapt designs to promote sustained, well-integrated community health programs at scale

show abstract

A framework for identifying and learning from countries that demonstrated exemplary performance in improving health outcomes and systems

Cited by 19 publications

References 26 publications

Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia

Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia

Community health workers at the dawn of a new era: 2. Planning, coordination, and partnerships

The Community Health Systems Reform Cycle: Strengthening the Integration of Community Health Worker Programs Through an Institutional Reform Perspective

Contact Info

Product

Resources

About