Malaria Community Health Workers in Eliminating Malaria in Banyumas Regency

Banyumas has not reached the elimination of malaria yet. One of the efforts is done by community empowerment by establishing malaria Community Health Workers (CHWs/JMD). JMD are people who conduct the discovery and medication of malaria in Active Case Detection (ACD). The research aims at describing JMDs attitude and knowledge towards the malaria elimination in Banyumas Regency in 2015. Quantitative research with cross sectional design was performed in the study. There were 15 JMDs spreading across in 7 public health centers/Puskesmas. The results show that most of JMDs were male with primary education background. They are mostly employed and do not join any training within 3 years. The average age of JMDs is 48.4 years old although there are some workers who are over 65 years old. 33.3% of JMDs are in low-medium categories, and there are 26.7% JMDs who have negative attitude to malaria. All JMDs have less skill such as not to do home visits as scheduled, not to do periodic reports, not to send blood preparations immediately and unstandardized of the blood preparation

Perception of Community Health Workers in Indonesia Toward Patients with Mental Disorders

In Indonesia, there are any community health volunteers called Kader. Although Kaders are members of mental health volunteer, they sometimes show negative attitude to psychotic persons, even they have already got some training about mental health. The aims of this study were to investigate 1) how is Kader's perception compare to the other countries, 2) how will they consult compare to the other countries 3) how is comparison of Kaders' perception to mental disorder person between trained and untrained. The method of this research is a descriptive explorative using survey study. This study was held on June to September 2013. It was conducted in five districts of Yogyakarta area with 619 respondents. The Questionnaires used contained three sections are follows; Part A is about Demographic Data, Part B two case vignettes (taken from MacArthur Health Module of the 1996 general Social Survey) and Part C about Kaders experiences. The perception of Kader as part of the community is lower than the general residence in the United States and Japan. The comparison between trained and untrained Kaders shown that trained Kaders has better perception toward patient with mental disorder. These results suggest that actual experiences in meeting the cases contributed to the improvement of Kaders' perception better than the previous mental health training did. It might be Kaders with short experience are explored information Kaders should be trained with more structured curriculum and recruiting Kader is recommended to recruit the young generation

Advancing Community Health Worker Practice and Utilization: The Focus on Financing

There is a growing interest in the use of community health workers in various roles in the US health care system. These workers go by various titles and names -- including promotora and community health advisor -- but all assist members of the communities they serve. As the role of these workers becomes more accepted and desirable in the overall system of care, they face the challenges of moving from being an exceptional add-on to the system to being more a part of the mainstream. Issues such as educational preparation, formal credentialing, licensure and compensation are all part of this process. In particular, various organizations are interested in but challenged by the need for sustainable financing of the CHW position. It is time to explore and develop viable financing arrangements that go beyond short-term grants.To address these concerns, this research was undertaken to study sustainable financing mechanisms for community health workers. The focus is on existing and emerging funding, reimbursement and payment policies for community health workers. The study seeks to identify promising examples and models of payment programs for community health workers generally in the United States. To the authors' knowledge, this is the first national project with this exclusive focus.The audiences for this report include community health workers, directors of programs that employ or work with community health workers, and administrators of public and private coverage programs such as health plans, insurance companies and state Medicaid programs seeking options for improving health care access and quality at the same or lower costs. Businesses, non-profit organizations and consumers exploring the possibilities of using the services community health workers could provide might also be interested in the findings

Community Health Workers and Promotores in California

Provides an overview of, and describes the challenges facing, the emerging workforce of public health professionals who carry out a variety of health promotion, case management, and service delivery activities at the community level

Community Health Workers: A Holistic Solution for Individual and Community Health

Community Health Workers (CHWs) go by many names, including outreach workers, patient navigators, peer health educators, and lay health advocates. CHWs help people overcome obstacles by accompanying them through treatment, monitoring needs for food and housing, leading education campaigns and empowering community members to take charge of their own health. As members of the communities they serve, CHWs establish relationships of trust with those they serve, bridging the gap between the clinic and community. Community Health Workers embrace a holistic conception of health, working not only in health care, but also with the social determinants of health such as poverty, education, and housing

Integrating community health workers into the formal health system to improve performance : a qualitative study on the role of on-site supervision in the South African programme

To explore the role of on-site supervision in community health worker (CHW) programmes and CHW integration into the health system. We compared the functioning of CHW teams reporting to a clinic-based nurse with teams supervised by a community-based nurse. We also consider whether a junior nurse can provide adequate supervision, given the shortage of senior nurses. A case study approach to study six CHW teams with different configurations of supervision and location. We used a range of qualitative methods: observation of CHW and their supervisors (126 days), focus group discussions (12) and interviews (117). South Africa where a national CHW programme is being implemented with on-site supervision. CHWs, their supervisors, clinic managers and staff, district managers, key informants from the community and CHW clients. Effective supervisors supported CHWs through household visits, on-the-job training, debriefing, reviewing CHWs' daily logs and assistance with compiling reports. CHWs led by senior nurses were motivated and performed a greater range of tasks; junior nurses in these teams could better fulfil their role. Clinic-based teams with senior supervisors were better integrated and more able to ensure continuity of care. In contrast, teams with only junior supervisors, or based in the community, had less engagement with clinic staff, and were less able to ensure necessary care for patients, resulting in lower levels of trust from clients. Senior supervisors raised CHW skills, and successfully negotiated a place for CHWs in the health system. Collaboration with clinic staff reduced CHWs' marginalisation and increased motivation. Despite being clinic-based, teams without senior supervisors had lower skill levels and were less integrated into the health system

The predictive validity of the Living Goods selection tools for community health workers in Kenya : cohort study

Background Ensuring that selection processes for Community Health Workers (CHWs) are effective is important due to the scale and scope of modern CHW programmes. However they are relatively understudied. While community involvement in selection should never be eliminated entirely, there are other complementary methods that could be used to help identify those most likely to be high-performing CHWs. This study evaluated the predictive validity of three written tests and two individual sections of a one-to-one interview used for selection into CHW posts in eight areas of Kenya. Methods A cohort study of CHWs working for Living Goods in eight local areas of Kenya was undertaken. Data on the selection scores, post-training assessment scores and subsequent on-the-job performance (number of household and pregnancy registrations, number of child assessments, proportion of on-time follow-ups and value of goods sold) were obtained for 547 CHWs. Kendall’s tau-b correlations between each selection score and performance outcome were calculated. Results None of the correlations between selection scores and outcomes reached the 0.3 threshold of an “adequate” predictor of performance. Correlations were higher for the written components of the selection process compared to the interview components, with some small negative correlations found for the latter. Conclusions If the measures of performance included in this study are considered critical, then further work to develop the CHW selection tools is required. This could include modifying the content of both tools or increasing the length of the written tests to make them more reliable, for if a test is not reliable then it cannot be valid. Other important outcomes not included in this study are retention in post and quality of care. Other CHW programme providers should consider evaluating their own selection tools in partnership with research teams

Primary Health Care in Practice: Is It Effective?

Primary health care is accepted as the model for delivering basic health care to low income populations in developing countries. Using El Salvador as a case study, the paper draws on three data sets and a qualitative survey to assess health care access and utilization across public and private sector options (including NGOs). Multivariate analysis is used to estimate the quantitative determinants of health seeking behavior. Physical and financial access is generally good. Households do not value the community health workers, and prefer high cost private care, even the poorest families, because of the lower waiting times and higher probability of successful treatment. Similarly, higher level public facilities—health centers and hospitals—are preferred because they are less costly in terms of time as they offer "one stop shopping" and do not require multiple visits, and treatment success is higher than among health posts, health units or community health workers. These results combined with the small size of El Salvador suggest that alternative strategies to community health workers may be a more cost effective approach. While prevention is desirable, community health workers do not have the skills or services that the communities value, which makes them less effective in promoting prevention. Alternative modes of reaching the community could reduce costs and raise the effectiveness of public health spending.health care, El Salvador, public health spending

Effectiveness of Community Health Workers

What is the evidence on the current use and role of community health workers in DRC and wider international systematic evidence on what works? Evidence supports Community Health Workers (CHWs) effectiveness in delivering a range of preventive, promotional and curative health services; reducing inequities in access to care; and supporting the empowerment of communities to demand social accountability from their governments and others to provide coverage of quality primary healthcare services. CHWs have the potential to contribute to the realisation of health-related goals, including universal health coverage. CHWs role should be clearly defined and they should be integrated into the health system and communities. CHWs are effective when supported in their education, career development, supervised, appropriately remunerated, and working under safe and decent conditions. Effective CHW initiatives and programmes should start with a situation analysis of population needs, health systems requirements and resource implications. WHO guideline recommendations to optimise CHW programmes should be adapted and contextualised to the reality of a specific health system. CHWs are defined by the International Labour Organization as health workers who “provide health education, referral and follow-up, case management, basic preventive health care and home visiting services to specific communities”. CHWs are often relied on in fragile and conflict-affected settings where they are embedded within the community and trusted, and where there is often a shortage of professional health workers. CHWs are well placed to understand gender norms and act to counter them especially where there are opportunities to break down gender barriers and stereotypes during reorganisation of health system governance and delivery after conflict