Community health worker

Last updated
Delivery of malaria treatment by a community health worker in Djenebougou, Mali Community Health Worker treats child (19165929668).jpg
Delivery of malaria treatment by a community health worker in Djénébougou, Mali

A community health worker (CHW) is a member of a community who provides basic health and medical care within their community, and is capable of providing preventive, promotional and rehabilitation care to that community, typically without formal education equal to that of a nurse, CHO, or doctor. They are chosen within the community to assist a train personnel community health extension worker who is train in college or schools of health. A community health extension worker (CHEW) is a specially trained professional who provides similar preventive, curative and rehabilitative health care and services to people where they live and work, the CHEW Are well trained for three years And they graduate with diploma While the JCHEW are trained for two years and graduate with certificate Other terms for this type of health care provider include lay health worker, village health worker, community health aide, community health promoter, and health advisor. [1] [2]

Contents

Community health officers contribute to community development and can help communities improve access to basic health services. They are most effective when they are properly trained to provide information and services to the community. [3] Community health officers are the most promising form of delivering health services to resource-constrained areas. They are seen as secondary health services in most low-income countries are available as a service to the community. [4]

In many developing countries, especially in Sub-Saharan Africa, there are critical shortages of doctors . [5] Current medical schools cannot train enough workers to keep up with increasing demand for health care services, internal and external emigration of health workers, deaths from AIDS and other diseases, low workforce productivity, and population growth. Community health officer are trained after completing their basic community health extension worker training in the colleges of health technologies, this training takes place in teaching hospitals that offers community health officer training to equip them with the knowledge to carry out more advanced health service in the rural areas. The community health officers work in primary health centre where they spent 70% of their time attending to patients and 30% in the community. community health officers can trained volunteer village health workers and community health workers chosen by the community that he or she works to help communicate with the local people.Programs involving community health officer in China, Brazil, Iran and Bangladesh [6] have demonstrated that utilizing such officer can help improve health outcomes for large populations in under-served regions.[ citation needed ] "Task shifting" of primary care functions from professional health workers to volunteer village health is considered to be a means to make more efficient use of the human resources currently available and improving the health of millions at reasonable cost. [7]

Community Health Officer (CHO)

Community Health Officer (CHO), also called Mid Level Health Provider (MLHP) and non-physician practitioner, are trained health care providers who have a defined scope of practice. [8] In India, only Nursing and AYUSH Practitioner are eligible for this cadre. [9] This means that they are trained and legally permitted to provide healthcare in fewer situations than physicians but more than other health professionals. [10] [11] In India, Community Health Officer is another name of Mid-Level Practitioner.

Recently in India, Community Health Officers at Ayushman Bharat Health and Wellness Centres are now allowed to supply certain medicines to the patients, as they have been included in Section 23 of Schedule K of Drugs and Cosmetics Rules, 1945. [12] In India, Community Health Officer (CHO) is another name of mid-level practitioner. [13]

Ministry of Health and family welfare, Government of India published guidelines for prevention and controlling of COVID-19 cases in rural area of India. According to guidelines Symptomatic cases can be triaged at village level by tele-consultation with Community Health Officer (CHO), and cases with comorbidity or low oxygen saturation should be sent to higher centres. [14] [15] [16] [17]

History

It is unclear where the usage of community health workers began, although China and Bangladesh have been cited as possible origins. Melinda Gates, co-founder of the Bill & Melinda Gates Foundation, said the nongovernmental organization BRAC in Bangladesh "pioneered the community health worker model." [18] Catherine Lovell writes that BRAC's decision to train locally recruited paramedics was "based on the Chinese barefoot doctor model then becoming known worldwide."

Scientific medicine has evolved slowly over the last few millennia and very rapidly over the last 150 years or so. As the evidence mounted of its effectiveness, belief and trust in the traditional ways waned. The rise of university-based medical schools, the increased numbers of trained physicians, the professional organizations they created, and the income and attendant political power they generated resulted in license regulations. Such regulations were effective in improving the quality of medical care but also resulted in a reduced supply of clinical care providers. This further increased the fees doctors could charge and encouraged them to concentrate in larger towns and cities where the population was denser, hospitals were more available, and professional and social relationships more convenient.

In the 1940s, Chairman Mao Zedong in China faced these problems. His anger at the "urban elite" medical profession over the maldistribution of medical services resulted in the creation of "Barefoot doctors". Hundreds of thousands of rural peasants, chosen by their colleagues, were given rudimentary training and assigned medical and sanitation duties in addition to the collective labor they owed the commune. By 1977, there were over 1.7 million barefoot doctors. [19] As professionally trained doctors and nurses became more available, the program was abolished in 1981 with the end of agricultural communes. Many Barefoot Doctors passed an examination and went to medical school. Many became health aides and some were relieved of duty.

Brazil undertook a medical plan named the Family Health Program in the 1990s that made use of large numbers of community health agents. Between 1990 and 2002, the infant mortality rate dropped from about 50 per 1000 live births to 29.2. [20] During that period the Family Health Program increased its coverage of the population from 0 to 36%. The largest impact appeared to be a reduction of deaths from diarrhea. Though the program utilized teams of physicians, nurses and community health workers, it could not have covered the population it did without the community health worker. Additionally, there is evidence in Brazil that the shorter period of training does not reduce the quality of care. In one study workers with a shorter length of training complied with child treatment guidelines 84% of the time whereas those with longer training had 58% compliance. [21]

Iran utilizes large numbers of para-professionals called behvarz. These workers are from the community and are based in 14,000 "health houses" nationwide. They visit the homes of the underserved providing vaccinations and monitoring child growth. Between 1984 and 2000 Iran was able to cut its infant mortality in half and raise immunization rates from 20 to 95%. The family planning program in Iran is considered highly successful. Fertility has dropped from 5.6-lifetime children per woman in 1985 to 2 in 2000. Though there are many elements to the program (including classes for those who marry and the ending of tax incentives for large families), behvarz are extensively involved in providing birth control advice and methods. The proportion of rural women on contraceptives in 2000 was 67%. The program resulted in a profound improvement in maternal mortality going from 140 per 100,000 in 1985 to 37 in 1996. [22]

The Government of Liberia launched the National Community Health Assistant Program in 2016 to accelerate progress towards universal health coverage for the most vulnerable populations, especially those in remote communities. [23] Liberia's program seeks to transform an existing cadre of unpaid and poorly coordinated community health workers into a more effective workforce by enhancing recruitment, supervision and compensation. [24] The health ministry has organized a coalition of funding and implementation partners to support this new program, which aims to train, supervise, equip and pay 4000 Community Health Assistants, supported by 400 clinical supervisors, to extend primary care services to 1.2 million people living in remote rural communities.

Scope of programs

The World Health Organization estimates there are over 1.3 million community health workers worldwide. [25] In addition to the large-scale implementation by countries such as China, India, Brazil, and Iran, many countries have implemented community health worker programs in small-scale levels for a variety of health issues.

In India, 600,000 community health workers are paid through a fee-for-service system to deliver a specific set of primary care functions, such as immunization. [26] They have also been found to be effective in delivering care for chronic conditions such as hypertension and diabetes, though there has been limited utilization of community health workers for these conditions. [27] In addition, community health workers have been utilized to increase mental health service utilization and decrease stigma associated with mental illness. [28] In this program respected female members of the community were chosen to participate. All of the women were married, came from a good social standing, displayed a keen interest in the program, and were encouraged by their family to participate. The women chosen were then trained in identification and referral of patients with mental illnesses, the common myths and misconceptions prevalent in the area and in conducting community surveys. The training lasted 3 days and included lectures, role plays and observation of patient interviews at the psychiatry outpatient department at St. John's Medical College Hospital. A population of 12,886 were surveyed using a brief questionnaire. Out of this population, 574 were suspected patients. Out of this 242 suspected patients visited the clinic after follow up from the community health worker. Also in India, The MINDS Foundation has developed a grassroots program targeted at providing mental health services to rural citizens. They leave the responsibility in the hands of local rural citizens who are trained as Community Mental Healthcare Workers (CMHWs). [29]

In Tanzania, village health workers were part of a community-based safe-motherhood approach. [30] The VHWs assisted pregnant women with birth planning, which included timely identification of danger signs, preparation, and accumulation of two or more essential supplies such as soap, razors, gloves for clean delivery, and mobilizing household resources, people and money to manage a possible emergency. Approximately one year after the CBRHP's major interventions ceased in these communities, most of the VHWs continued to do health promotion by visiting pregnant women, teaching them about birth planning and danger signs, and assisting them in obtaining both prenatal and obstetric services. Local VHW associations are forming with support from local political leaders, the Ministry of Health, and the non-governmental organization CARE to sustain the work of the VHWs. The community development officers, some of whom were also the master trainers, are involved in spearheading the formation of VHW organizations.

In Mali, community health workers with the Mali Health Organizing Project in Bamako have helped reduce child mortality (under 5 years old) in their community to less than 1%, compared to a national average of 19%. [31]

The use of community health workers is not limited to developing countries. In New York, they have been deployed across the state to provide care to patients with chronic illnesses like diabetes that require sustained, comprehensive care. They work in both rural communities where access to primary care is sparse, and in urban communities where they are better able to bridge communication gaps that may arise between patients and doctors. They are seen to play an important role in assisting patients with navigating a complex, uncoordinated health care system. [32] In Philadelphia, a standardized intervention was used by community health workers across multiple systems provided evidence of increased patient-perceived quality of care and hospitalization reduction among low-income populations. [33]

A randomized controlled intervention on the U.S.-Mexico border, used promotoras or "female promoters" to increase the number of women utilizing routine preventive examinations. [34] The control group received a postcard reminding women to get a preventive screening. The free comprehensive clinical exam included a Pap test, a clinical breast exam, human papillomavirus (HPV) testing, blood draw for total cholesterol and blood glucose, and a blood pressure measurement. The other group received the same postcard and a follow-up visit from a promotora. The group that was followed up by a promotora saw a 35% increase in visits to get the free screening. [35]

A program in Karnataka, India took a slightly different approach now referred to as the "link worker" model. The Samastha project developed a network in which trained workers, village health committees, government facilities, people living with HIV (PLHIV) networks, and participating NGOs collaborated to improve recruitment and retention of PLHIV while strengthening and supporting their adherence to treatment. Link workers were PLHIV who were selected by Samastha from a small number of HIV-positive candidates proposed by their community; they received an allowance for their work. The link workers' key tasks revolved around prevention, stigma reduction, and support for PLHIV that included adherence support to both treatment and care. Ultimately, the link workers' coordinating role became a hallmark of Samastha's interventions in high prevalence rural areas. Link workers formed the essential connection between PLHIV, government and community structures, and HIV care and treatment services, commonly accompanying persons from their catchment area to these services.

Community health workers have also been utilized to assist in research. Martin et al. found that the Latin-American population in the United States frequently does not benefit from health programs due to language barriers, distrust of the government, and unique health beliefs and practices, and specifically that providing effective asthma care to the Latino population is an enormous challenge. [36] In addition, they found that Latinos are also often excluded from research due to a lack of validated research instruments in Spanish, unsuccessful study recruitment, and a limited number of Latino researchers. [37] Thus, Martin and colleagues decided to use community health workers to recruit participants. To gauge the effectiveness of their recruitment strategy to other more traditional recruitment models they looked at two studies. Both these studies offered significant monetary incentives for participation while the community health worker study offered nothing for the initial participation. Martin et al. found that individuals who chose not to participate in the study went on to receive other services in the areas of diabetes and cancer prevention, which was not the case for the other studies.

In the Philippines, community health workers are known as barangay health volunteers. With the decentralization of healthcare through the 1991 Local Government Code, the responsibility of delivery of primary health services were transferred from the central government to locally elected provincial, city, and municipal governments. They provide preventive health services and treatments, especially for the poor. [38]

Community health workers play a variety of critical roles in pandemic response. [39]

Current status

Cost and access to medical care remain problems of worldwide scope. They are particularly severe in the developing world and it is estimated one million more health care workers are needed in Africa to meet the health-related Millennium Development Goals. [40] Doctors are few and concentrated in cities. In Uganda, some 70% of medical doctors and 40% of nurses and midwives are based in urban areas, serving only 12% of the population. [41] Medical training is long and expensive. It is estimated that to meet health workforce needs using the American or European model, Africa would need to build 300 medical schools with a total training cost of over $33 billion and it would take over 20 years just to catch up. [40] In many countries the salaries of doctors and nurses are less than that of engineers and teachers. Bright young medical professionals often leave practice for more lucrative opportunities. [40] Emigration of trained personnel to countries with higher salaries is high. In Zambia of the 600 doctors trained since independence, it is estimated only 50 practice in their home country. [42] In some countries, AIDS is killing experienced nurses and doctors amounting to 30-50% of the number trained yearly. [43] Though many countries have increased their spending on health care and foreign money has been injected, much of it has been on specific disease-oriented programs. [44] Health systems remain extremely weak, especially in rural areas. The World Health Assembly in 2006 called for, "A health workforce which is matched in number, knowledge and skillsets to the needs of the population and which contributes to the achievement of health outcomes by utilizing a range of innovative methods". [5]

Community health workers are thought to be part of the answer. [45] They can be trained to do specialized tasks such as provide sexually transmitted disease counseling, directly observed therapy for tuberculosis control, or act as trained birth attendants. Others work on specific programs performing limited medical evaluations and treatment. Others have a far broader primary care function. With training, monitoring, supervision, and support such workers have been shown to be able to achieve outcomes far better than baseline and in some studies, better than physicians. [46] [47] [48] [49]

Important attributes of community health workers are to be a member of and chosen by the community they serve. [50] This means they are easily accepted by their fellows and have natural cultural awareness. This is crucial because many communities are disengaged from the formal health system. In Sub-Saharan Africa, 53% of the poorest households do not seek care outside the home. [44] Barriers include clinic fees, distance, community beliefs and the perception of the skills and attitudes of medical clinic workers. Community health workers are unable to emigrate because they do not have internationally recognized qualifications. [45] Finally, the variation in incentives between areas of the country tends to below. All these factors combined with strong community ties, tend to result in retention at the community level.

Much remains to be learned about the recruitment, training, functions, incentives, retention and professional development of community health workers. Learning developed in one country may not be applicable to another due to cultural differences. Health worker adaptability to local requirements and needs is key to improving medical outcomes. [44] That being said, it has been estimated that six million children's lives a year could be saved if 23 evidence-based interventions were provided systematically the children living in the 42 countries responsible for 90% of childhood mortality. [51] Over 50% of this benefit could be obtained with an integrated, high-coverage, family-community care based system. [52] Community health workers may be an integral and crucial component of the health human resources team needed to achieve such goals.

See also

Related Research Articles

<span class="mw-page-title-main">Emergency medicine</span> Medical specialty concerned with care for patients who require immediate medical attention

Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians specialize in providing care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with emergency medical services, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency medical physicians generally practice in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics.

<span class="mw-page-title-main">Healthcare industry</span> Economic sector focused on health

The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.

<span class="mw-page-title-main">Clinic</span> Outpatient health care facility

A clinic is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs of populations in local communities, in contrast to larger hospitals which offer more specialized treatments and admit inpatients for overnight stays.

<span class="mw-page-title-main">Community health</span> Field of public health

Community health refers to simple health services that are delivered by laymen outside hospitals and clinics. Community health is also the subset of public health that is taught to and practiced by clinicians as part of their normal duties. Community health volunteers and community health workers work with primary care providers to facilitate entry into, exit from and utilization of the formal health system by community members.

<span class="mw-page-title-main">Barefoot doctor</span> 1968–1981 doctor in rural China

Barefoot doctors were healthcare providers who underwent basic medical training and worked in rural villages in China. They included farmers, folk healers, rural healthcare providers, and recent middle or secondary school graduates who received minimal basic medical and paramedical education. Their purpose was to bring healthcare to rural areas where urban-trained doctors would not settle. They promoted basic hygiene, preventive healthcare, and family planning and treated common illnesses. The name comes from southern farmers, who would often work barefoot in the rice paddies, and simultaneously worked as medical practitioners.

<span class="mw-page-title-main">Family medicine</span> Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.

Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.

<span class="mw-page-title-main">Primary care physician</span> US term for medical professional providing first-line care

A primary care physician (PCP) is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. The term is primarily used in the United States. In the past, the equivalent term was 'general practitioner' in the US; however in the United Kingdom and other countries the term general practitioner is still used. With the advent of nurses as PCPs, the term PCP has also been expanded to denote primary care providers.

A health professional, healthcare professional, or healthcare worker is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician, physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.

Uganda's health system is composed of health services delivered to the public sector, by private providers, and by traditional and complementary health practitioners. It also includes community-based health care and health promotion activities.

<span class="mw-page-title-main">Healthcare in China</span> Overview of the health care system in China

Healthcare in China has undergone basic changes over the twentieth century and twenty-first century, using both public and private medical institutions and insurance programs. As of 2020, about 95% of the population has at least basic health insurance coverage. Basic medical insurance includes two systems: employee medical insurance and resident medical insurance. The former covers the urban employed population, and the latter covers the urban non-employed population and the rural population. A total of 25% of the people covered by the basic medical insurance participated in the employee medical insurance, a total of 344 million people; 75% participated in the residents' medical insurance, a total of 1.017 billion people. Medical assistance has subsidized 78 million poor people to participate in basic medical insurance, and the coverage of poor people has stabilized at over 99.9%. Despite this, Public health insurance generally only covers about half of medical costs, with the proportion lower for serious or chronic illnesses. Under the "Healthy China 2020" initiative, China has undertaken an effort to cut healthcare costs, requiring insurance to cover 70% of costs by the end of 2018. In addition, there are policies such as critical illness insurance and medical assistance. China's commercial health insurance is also proliferating. In 2020, the country's commercial health insurance premium income amounted to 817.3 billion yuan, with an average annual growth rate of 20%. China's coverage of maternity insurance has continued to expand, by the end of 2020, 235.673 million people were insured under maternity insurance.

<span class="mw-page-title-main">Healthcare in Senegal</span> Overview of the health care system in Senegal

Healthcare in Senegal is a center topic of discourse in understanding the well-being and vitality of the Senegalese people. As of 2008, there was a need to improve Senegal's infrastructure to promote a healthy, decent living environment for the Senegalese.

The Comprehensive Rural Health Project (CRHP) is a non profit non-governmental organisation located in the Ahmednagar District of Maharashtra State in India. The organization works with rural communities to provide community-based primary healthcare and improve the general standard of living through a variety of community-led development programs, including Women's Self-Help Groups, Farmers' Clubs, Adolescent Programs, and Sanitation and Watershed Development Programs. CRHP was founded in 1970 by Dr. Raj and Dr. Mabelle Arole, who conceived the Organisation's model while on a Fulbright Scholarship in Maharashtra. The work of CRHP has been recognized by the Government of Maharashtra and UNICEF, as well as being introduced to 178 countries across the world. The purpose of CRHP is to help provide healthcare to the poor.

The public healthcare system in India evolved due to a number of influences since 1947, including British influence from the colonial period. The need for an efficient and effective public health system in India is large.

<span class="mw-page-title-main">Healthcare in India</span> Overview of the health care system in India

India has a multi-payer universal health care model that is paid for by a combination of public and government regulated private health insurances along with the element of almost entirely tax-funded public hospitals. The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services.

<span class="mw-page-title-main">Women's health in India</span> Demographic health topic

Women's health in India can be examined in terms of multiple indicators, which vary by geography, socioeconomic standing and culture. To adequately improve the health of women in India multiple dimensions of wellbeing must be analysed in relation to global health averages and also in comparison to men in India. Health is an important factor that contributes to human wellbeing and economic growth.

Suniti Solomon was an Indian physician and microbiologist who pioneered AIDS research and prevention in India after having diagnosed the first Indian AIDS cases among the Chennai sex workers in 1986 along with her student Sellappan Nirmala. She founded the Y R Gaitonde Centre for AIDS Research and Education in Chennai. The Indian government conferred the National Women Bio-scientist Award on her. On 25 January 2017, the Government of India awarded her the Padma Shri for medicine for her contributions towards diagnosis and treatment of HIV.

<span class="mw-page-title-main">Raj Panjabi</span> American physician (born 1981)

Raj Panjabi is an American physician, social entrepreneur, professor and former White House official.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on hospitals</span> Consequences of COVID-19 pandemic for hospitals

The COVID-19 pandemic has impacted hospitals around the world. Many hospitals have scaled back or postponed non-emergency care. This has medical consequences for the people served by the hospitals, and it has financial consequences for the hospitals. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Health facilities in many places are closing or limiting services. Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity. The pandemic also resulted in the imposition of COVID-19 vaccine mandates in places such as California and New York for all public workers, including hospital staff.

<span class="mw-page-title-main">Health Care In Danger</span> Red Cross campaign

Health Care In Danger is a campaign organized by the International Committee of the Red Cross that highlights violent attacks on patients, healthcare workers, and healthcare facilities in conflict zones.

References

  1. ↑ International Labour Organization. International Standard Classification of Occupations, 2008 revision. Geneva, ILO.
  2. ↑ Nkonki L, Cliff J, Sanders D (December 2011). "Lay health worker attrition: important but often ignored". Bulletin of the World Health Organization. 89 (12): 919–23. doi:10.2471/BLT.11.087825. PMC   3260896 . PMID   22271950.
  3. ↑ Lehmann U (January 2007). "Community health officer: What do we know about them?" (PDF). World Health Organization.
  4. ↑ Perry H (September 2012). "How Effective Are Community Health officer?" (PDF). Johns Hopkins Bloomberg School of Public Health. Archived from the original (PDF) on 2020-02-21. Retrieved 2018-04-17.
  5. 1 2 World Health Organization, 2006. The World Health Report 2006: working together for health. Geneva, WHO Press.
  6. ↑ iraj S, Shabnam F, Jalal CS, Zongrone A, Afsana K (2010). ""Shasthya Shebika's" Role in Improving Infant and Young Child Feeding Practices in Rural Bangladesh: BRAC's Experience". Geneva Health Forum.
  7. ↑ World Health Organization (2007). "Task shifting to tackle health officer shortages" (PDF). Geneva: WHO.
  8. ↑ "Over 12 lakh people treated for free under Ayushman Bharat; 10000 Wellness Centres operational". Jagranjosh.com. 2019-02-23. Retrieved 2021-05-18.
  9. ↑ "Why we need community health providers". Hindustan Times. 2019-08-13. Retrieved 2021-03-29.
  10. ↑ "Ministry of Health & Family Welfare 2020 ACHIEVEMENTS". www.pib.gov.in. Retrieved 2021-03-30.
  11. ↑ "Roles and responsibilities of mid level health provider-Indian Journals". www.indianjournals.com. Retrieved 2021-03-29.
  12. ↑ "Anganwadi Workers, Community Health Officers at Ayushman Bharat Health and Wellness Centres now under Schedule K of Drugs and Cosmetics Rules". medicaldialogues.in. 2021-03-03. Retrieved 2021-03-29.
  13. ↑ "NMC Bill's Mid-Level Community Health Provider An Interim Option: Health Ministry". NDTV.com. Retrieved 2021-07-20.
  14. ↑ "Centre issues guidelines on Covid-19 management in rural, peri-urban areas". The Indian Express. 2021-05-16. Retrieved 2021-05-18.
  15. ↑ "Centre releases Covid-19 guidelines for rural areas, focus on surveillance, screening". Hindustan Times. 2021-05-16. Retrieved 2021-05-18.
  16. ↑ "Amid rising COVID-19 cases in rural areas, Centre's guidelines to contain virus spread – Check here". www.timesnownews.com. 16 May 2021. Retrieved 2021-05-18.
  17. ↑ "Govt issues guidelines on Covid management in rural, peri-urban areas". The Times of India. May 16, 2021. Retrieved 2021-05-18.
  18. ↑ Kristof ND (11 January 2012). "Melinda Gates Answers Questions, Part II". The New York Times. Retrieved 18 September 2013.
  19. ↑ Rosenthal MM, Greiner JR (Winter 1982). "The Barefoot Doctors of China: from political creation to professionalization". Human Organization. 41 (4): 330–41. doi:10.17730/humo.41.4.h01v12784j114357. PMID   10299059.
  20. ↑ Macinko J, Guanais FC, de Fátima M, de Souza M (January 2006). "Evaluation of the impact of the Family Health Program on infant mortality in Brazil, 1990-2002". Journal of Epidemiology and Community Health. 60 (1): 13–9. doi:10.1136/jech.2005.038323. PMC   2465542 . PMID   16361449.
  21. ↑ Huicho L, Scherpbier RW, Nkowane AM, Victora CG (September 2008). "How much does quality of child care vary between health workers with differing durations of training? An observational multicountry study". Lancet. 372 (9642): 910–6. doi:10.1016/S0140-6736(08)61401-4. PMID   18790314. S2CID   40738106.
  22. ↑ Roudi-Fahimi F, Bureau PR (2003). "Women's reproductive health in the Middle East and North Africa". CiteSeerX   10.1.1.364.2652 .
  23. ↑ Luckow PW, Kenny A, White E, Ballard M, Dorr L, Erlandson K, et al. (February 2017). "Implementation research on community health workers' provision of maternal and child health services in rural Liberia". Bulletin of the World Health Organization. 95 (2): 113–120. doi:10.2471/BLT.16.175513. PMC   5327932 . PMID   28250511.
  24. ↑ "Community Health Workers for Advancing Liberian Livelihoods Activity | Fact Sheet | Liberia |". U.S. Agency for International Development. November 21, 2016.
  25. ↑ World Health Organization (2011). "World Health Statistics 2011". Archived from the original on May 18, 2011. Table 6: Health workforce, infrastructure and essential medicines
  26. ↑ Singh, Prabhjot (2013). "Community health workers--a local solution to a global problem". New England Journal of Medicine. 369 (10): 894–896. doi:10.1056/NEJMp1305636. PMID   24004115.
  27. ↑ Khetan, Aditya (2019). "Effect of a Community Health Worker-Based Approach to Integrated Cardiovascular Risk Factor Control in India: A Cluster Randomized Controlled Trial". Global Heart. 14 (4): 355–365. doi:10.1016/j.gheart.2019.08.003. PMC   7358973 . PMID   31523014.
  28. ↑ Isaacs AN, Srinivasan K, Neerakkal I, Jayaram G (2006). "Initiating a Community Mental Health Programme in Rural Karnataka". Indian Journal of Community Medicine. 31 (2): 86–87.
  29. ↑ "The MINDS Foundation". The MINDS Foundation.
  30. ↑ Ahluwalia IB, Schmid T, Kouletio M, Kanenda O (August 2003). "An evaluation of a community-based approach to safe motherhood in northwestern Tanzania". International Journal of Gynaecology and Obstetrics. 82 (2): 231–40. doi: 10.1016/s0020-7292(03)00081-x . PMID   12873791. S2CID   25620173.
  31. ↑ "Annual Report 2011". Data and Reports. Mali Health Organizing Project. Archived from the original on 2013-08-12. Retrieved 2013-03-22.
  32. ↑ New York State Health Foundation: Health Workers.
  33. ↑ Kangovi, Shreya; Mitra, Nandita; Norton, Lindsey; Harte, Rory; Zhao, Xinyi; Carter, Tamala; Grande, David; Long, Judith A. (2018-12-01). "Effect of Community Health Worker Support on Clinical Outcomes of Low-Income Patients Across Primary Care Facilities: A Randomized Clinical Trial". JAMA Internal Medicine. 178 (12): 1635–1643. doi:10.1001/jamainternmed.2018.4630. ISSN   2168-6106. PMC   6469661 . PMID   30422224.
  34. ↑ Hunter JB, de Zapien JG, Papenfuss M, Fernandez ML, Meister J, Giuliano AR (August 2004). "The impact of a promotora on increasing routine chronic disease prevention among women aged 40 and older at the U.S.-Mexico border". Health Education & Behavior. 31 (4 Suppl): 18S–28S. doi:10.1177/1090198104266004. PMID   15296689. S2CID   39714650.
  35. ↑ "Linking Resources for Antiretroviral Adherence". AIDSTAR-One. Archived from the original on 2015-02-08. Retrieved 2012-08-17.
  36. ↑ Martin M, Hernández O, Naureckas E, Lantos J (December 2005). "Improving asthma research in an inner-city Latino neighborhood with community health workers". The Journal of Asthma. 42 (10): 891–5. doi:10.1080/02770900500371443. PMID   16393730. S2CID   22071091.
  37. ↑ Flores G, Fuentes-Afflick E, Barbot O, Carter-Pokras O, Claudio L, Lara M, et al. (July 2002). "The health of Latino children: urgent priorities, unanswered questions, and a research agenda". JAMA. 288 (1): 82–90. doi:10.1001/jama.288.1.82. PMID   12090866.
  38. ↑ Lakshminarayanan R (May 2003). "Decentralisation and its implications for reproductive health: the Philippines experience". Reproductive Health Matters. 11 (21): 96–107. doi: 10.1016/s0968-8080(03)02168-2 . PMID   12800707. S2CID   14318790.
  39. ↑ Bhaumik, Soumyadeep; Moola, Sandeep; Tyagi, Jyoti; Nambiar, Devaki; Kakoti, Misimi (June 2020). "Community health workers for pandemic response: a rapid evidence synthesis". BMJ Global Health. 5 (6): e002769. doi:10.1136/bmjgh-2020-002769. ISSN   2059-7908. PMC   7292038 . PMID   32522738.
  40. 1 2 3 Conway MD, Gupta S, Khajavi K (2008). "Addressing Africa's health workforce crisis". McKinsey Quarterly. 1: 98.
  41. ↑ Human Resource Strategic Plan for Uganda, 2005–2020 (Report). Kampala: Uganda Ministry of Health. 2006.
  42. ↑ Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. (2004). "Human resources for health: overcoming the crisis" (PDF). Lancet. 364 (9449): 1984–90. doi:10.1016/S0140-6736(04)17482-5. PMID   15567015. S2CID   21087238.
  43. ↑ Hongoro C, McPake B (2004). "How to bridge the gap in human resources for health". Lancet. 364 (9443). London, England: 1451–6. doi:10.1016/S0140-6736(04)17229-2. PMID   15488222. S2CID   6363611.
  44. 1 2 3 "People First: African solutions to the health worker crisis" (PDF). African Medical and Research Foundation (AMREF). Archived from the original (PDF) on 2011-08-31. 2007.
  45. 1 2 McPake B, Mensah K (September 2008). "Task shifting in health care in resource-poor countries". Lancet. 372 (9642): 870–1. doi:10.1016/S0140-6736(08)61375-6. PMID   18790295. S2CID   28747431.
  46. ↑ Perez F, Aung KD, Ndoro T, Engelsmann B, Dabis F (December 2008). "Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: a feasibility study". BMC Public Health. 8: 401. doi: 10.1186/1471-2458-8-401 . PMC   2612666 . PMID   19061506.
  47. ↑ Lehmann U, Friedman I, Sanders D (February 2004). "Review of the utilisation and effectiveness of community-based health workers in Africa". Global Health Trust, Joint Learning Initiative on Human Resources for Health and Development (JLI), JLI Working Paper. S2CID   15631172.
  48. ↑ Swider SM (2002). "Outcome effectiveness of community health workers: an integrative literature review". Public Health Nursing. 19 (1): 11–20. doi:10.1046/j.1525-1446.2002.19003.x. PMID   11841678.
  49. ↑ Hopkins H, Talisuna A, Whitty CJ, Staedke SG (October 2007). "Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence". Malaria Journal. 6: 134. doi: 10.1186/1475-2875-6-134 . PMC   2170444 . PMID   17922916.
  50. ↑ World Health Organization (2007). "Community health workers: What do we know about them?" (PDF). WHO Evidence and Information for Policy, Department of Human Resources for Health.
  51. ↑ Bryce J, Black RE, Walker N, Bhutta ZA, Lawn JE, Steketee RW (2005). "Can the world afford to save the lives of 6 million children each year?". Lancet. 365 (9478): 2193–200. doi:10.1016/S0140-6736(05)66777-3. PMID   15978927. S2CID   46067330.
  52. ↑ Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L (2005). "Evidence-based, cost-effective interventions: how many newborn babies can we save?". Lancet. 365 (9463): 977–88. doi:10.1016/S0140-6736(05)71088-6. PMID   15767001. S2CID   14801796.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.