Prioritising the role of community health workers in the COVID-19 response

Abstract

COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targeted actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.

A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income Countries

“…CHWs can also carry out surveillance of risk factors and implement preventive and self-management strategies for PLWNCDs, who are at high risk of COVID-19. Potential CHW roles in COVID-19 management include community engagement, community sensitization, promoting isolation and quarantine, and performing contact tracing (44,45). Despite their huge potential in pandemic management, CHWs have been underutilized in the COVID-19 pandemic, especially in countries where CHWs are available, such as Bangladesh, India, and Nepal.…”

Agente comunitário de saúde: reflexões sobre o processo de trabalho em saúde em tempos de pandemia de Covid-19

“…The review of the evidence [23][24][25][26][27] on the CHW work in pandemic contexts, indicates that they represent a significant part of the workforce in the front line and can be valuable in pandemics control and prevention such as COVID-19. In countries with well-established programs, the CHW functions and tasks transform during pandemics because of the need to redefine normal procedures for conducting routine activities.…”

“…In countries with well-established programs, the CHW functions and tasks transform during pandemics because of the need to redefine normal procedures for conducting routine activities. Besides training, supervision, and support, it is recommended that these professionals receive adapted and continuously updated guidance [23][24][25][26][27] .…”

“…It is opportune to use this moment to investigate the number of rooms and resident people in the household, considering the age group and the presence of comorbidities, as well as the conditions of access to basic sanitation, in order to carry out, preliminarily, a risk analysis for coronavirus 29 . Haines et al 25 and Ballard et al 26 point out that home visits are key opportunities for situational diagnosis of vulnerabilities, as it allows the identification of users/ families in extreme poverty, food insecurity, and vulnerable groups. Chatterjee 27 draws attention to the demanding intersectoral character, since, by identifying the most vulnerable, the CHW can activate other instances of the health system and of the protection and social assistance services.…”

Considerations for planning COVID-19 treatment services in humanitarian responses

“…for worsening symptoms); • Identify people with risk factors for severe COVID-19, advising them on care-seeking and promoting earlier supportive treatment if COVID-19 symptoms occur (e.g. antipyretics) [ 5 ]; • Involve community health workers (CHWs) in COVID-19 treatment service delivery, appropriate to their current workload and skillset, as a secondary priority after COVID-19 risk communication and behaviour change promotion [ 6 ]: CHW involvement may include advice on home care, treatment seeking and self-isolation; identification, monitoring and advice to people at high-risk of severe COVID-19; support for home based palliative care [ 7 ] and delivery of drugs and supplies to reduce patients’ need to visit health facilities; • Follow up for high-risk patients discharged from inpatient care who could develop/ have developed complications (e.g. poor nutritional status, respiratory difficulties).…”