Hello all! Thanks for joining our discussion on CHW performance. I’ll offer a few brief thoughts and questions to kick us off; I am looking forward to a spirited discussion!
Community health workers (CHWs) were widely promoted as a means to provide primary healthcare in resource poor settings as early as the 1978 Alma-Ata Declaration . A series of reviews in the late 1980s and early 1990s, however, found that large-scale CHW programs often failed to replicate the success of smaller community-based programs [2-7]. Since this period, rigorous evidence accumulated on the efficacy of CHWs to deliver assorted health interventions [8-11]. Yet the most recent evaluations of national-scale CHW programs remain unfavorable [12-14].
It is difficult to assess on the basis of such evaluations, however, whether a given CHW program did not achieve the desired outcome because (i) such programs do not work, (ii) a given program was not implemented properly (type III error), or (iii) the CHW program design was not yet optimised to achieve maximum effect (e.g. via the best or most efficient combination and dose of intervention components) [15-18]. Given this,
- How should we measure the quality of CHW programs? What might a CHW quality standard or checklist look like?
- What evidence exists about improving CHW performance? (I have attached a few examples of relevant research here: Ashraf and colleagues on CHW recruitment, De Renzi and colleagues on mobile-supported CHW supervision, and Andreoni and colleagues on CHW incentives )
-What questions remain unanswered and what type of research might help answer them?
Link leads to: http://www.hbs.edu/faculty/Pages/item.aspx?num=46043
Link leads to: http://tap2k.org/papers/p25-derenzi.pdf
Link leads to: http://www.3ieimpact.org/en/evidence/impact-evaluations/details/237/