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Community health workers for universal health-care coverage: from fragmentation to synergy

Bulletin of the World Health Organization, 2013-11, Vol.91 (11), p.847-852 [Peer Reviewed Journal]

Copyright World Health Organization Nov 2013 ;(c) World Health Organization (WHO) 2013. All rights reserved. 2013 ;ISSN: 0042-9686 ;EISSN: 1564-0604 ;DOI: 10.2471/blt.13.118745 ;PMID: 24347709 ;CODEN: BWHOA6

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Title:
Community health workers for universal health-care coverage: from fragmentation to synergy
Author: Tulenko, Kate ; Møgedal, Sigrun ; Afzal, Muhammad Mahmood ; Frymus, Diana ; Oshin, Adetokunbo ; Pate, Muhammad ; Quain, Estelle ; Pinel, Arletty ; Wynd, Shona ; Zodpey, Sanjay
Subjects: Alliances ; Capacity Building - organization & administration ; Career planning ; Communities ; Community health services ; Community Health Workers - education ; Community Health Workers - organization & administration ; Demand ; Employment ; Failure ; Family planning ; Fragmentation ; Global Health ; Health ; Health care ; Health insurance ; Health Manpower - organization & administration ; Health Policy & Services ; Health services ; Health Services Accessibility - organization & administration ; Health Services Needs and Demand ; HIV ; Hospitals ; Human immunodeficiency virus ; Humans ; Immunization ; Investments ; Leadership ; Maternal & child health ; Medical personnel ; Medical service ; NGOs ; Nongovernmental organizations ; Policies ; Policy & Practice ; Primary care ; Public health ; Public sector ; Supervision ; Sustainability ; Theme Issue ; Training ; World Health Organization
Is Part Of: Bulletin of the World Health Organization, 2013-11, Vol.91 (11), p.847-852
Description: To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs' contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people's access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs' skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress.
Publisher: Switzerland: World Health Organization
Language: English;Portuguese
Identifier: ISSN: 0042-9686
EISSN: 1564-0604
DOI: 10.2471/blt.13.118745
PMID: 24347709
CODEN: BWHOA6
Source: SciELO
Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
PubMed Central
ProQuest Central
DOAJ Directory of Open Access Journals

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Community health workers for universal health-care coverage: from fragmentation to synergy

Copyright World Health Organization Nov 2013 ;(c) World Health Organization (WHO) 2013. All rights reserved. 2013 ;ISSN: 0042-9686 ;EISSN: 1564-0604 ;DOI: 10.2471/blt.13.118745 ;PMID: 24347709 ;CODEN: BWHOA6

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