Community Health Workers in Pandemics: Evidence and Investment Implications

Abstract

A strong and accessible national health system, including at the community level, is critical for pandemic preparedness and response.n Community health workers who are equipped, trained, and paid as part of a well-functioning health system can help prevent epidemics from becoming pandemics and maintain health care delivery amid significant disruption. n To achieve resilient health systems, bi/multilateral aid and private philanthropies need to review their investment practices to replace those that cause harm (high transaction costs, earmarking, short-termism, appropriation of sovereignty) with practices that ensure timely and effective implementation of priorities set by government stakeholders (pooling, longer commitments, and alignment with evidence-based guidelines) CHWS ARE CRITICAL TO KEEPING PANDEMICS IN CHECKCHWs-if equipped with ongoing training, supervision, remuneration, medical commodities, and personal protective equipment (PPE)-can prevent, detect, and respond to pandemics by carrying out tasks as diverse as leading community-based infection prevention and control, facilitating safe sample collection, conducting contact tracing, accelerating vaccination roll-out, and

Expert perspectives on priorities for supporting health security in the Pacific region through health systems strengthening

“…The FGD findings on workforce development align with recent literature that recommends investing in strengthening the capacity of the health workforce of the Pacific, specifically community health workers [2,12,22]. In 2019, WHO reported the latest available data on density of doctors per 10,000 population by country.…”

Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies

“…Our synthesis showed that apart from routine service delivery CHWs were actively involved in COVID-19 activities such as contact tracing, community education and awareness on COVID-19, screening people with potential COVID-19 symptoms, counselling migrants. Similar roles in both the COVID-19 response and continued delivery of routine services during COVID-19 have been identified by other research, both in some countries included in our research, such as India, Sierra Leone and Kenya and in other contexts, as well as in global syntheses [8,16,18,22,[83][84][85].…”

“…Many CHWs experience difficult working conditions and weak employment status during routine times [100], as noted in our synthesis in relation to the normality of fragile financial payments. Action taken to support CHWs during COVID-19 should address the systemic issues affecting CHWs, going beyond short-term measures to support stronger ongoing health system resilience and CHWs well-being [83,100].…”

Pivotal role of CHWs in prevention, early detection and control of outbreaks: neglected key primary players; a call to action

“…And this can be achieved through CHWs. When empowered and properly prepared in terms of training and accessories, CHWs might be among the cost-effective and yet successful approaches in addressing different outbreaks of public health concern 2 .…”