The community health system in the DRC: An overview

This brief provides an overview of the community health system in the Democratic Republic of the Congo (DRC). The community health system is decentralized and operates across five levels: national, provincial, health zone, health area, and community. Various policy documents guide DRC’s community health system, including The National Health Development Plan 2016–2020. Relais communautaire (RECOs) are the main cadre of community health workers operating in the DRC. They are volunteers who provide a minimum package of reproductive, maternal, newborn, and child health services, including the provision of family planning; integrated community case management for malaria, diarrhea, and respiratory diseases; nutrition counseling; water, sanitation, and hygiene (WASH), HIV, and AIDS education; and disease prevention. RECOs conduct home visits to approximately 50 households per month. They also provide referrals to health facilities and conduct community-based surveillance. RECOs collaborate largely with the Community Outreach Unit to plan, implement, and monitor interventions and the services they provide

The community health system in Mali: An overview

This brief provides an overview of the community health system in Mali. The system is decentralized and operates across five levels: national, regional, district, health area, and community. It relies on two cadres of community health workers to deliver health-care services, primarily to rural populations: agents de santé communautaire (ASCs) and relais communautaire. The National Implementation Guide for Essential Community Health Care is the main document that outlines responsibilities of community health providers and processes for organization, management, and delivery of health services. Although Mali’s maternal, child (under five years), and infant mortality rates have fallen over the past two decades, they still remain among the highest in the world. To reduce the number of maternal, child, and infant deaths and significantly improve health outcomes for the general population, the government is introducing a series of national health-care reforms, expected to take full effect by 2022. They include: providing contraceptives free of charge; free preventative and curative health care for children under five and pregnant women; increasing national budget allocations to health; adding thousands of ASCs to the health workforce and standardizing their role within the national health system

Operationalized indicators: Integrating community health worker and client views to assess community health systems

This guide is intended for policy makers, program managers, and implementers to use in meaningfully integrating community health worker (CHW) and community perspectives when assessing community health system performance and tracking improvements over time. It complements the portfolio of existing global measurement tools that inform country community health monitoring and evaluation frameworks and support localized decision-making. The guide recommends considering application and integration of a brief and full sets of indicators. The brief set includes 20 indicators (13 at CHW level and 7 at community member/client level) while the longer set includes 30 indicators (19 at CHW level, 11 at community member/client level). The guide recommends mapping out potential modes and timing of data collection (existing and new) for integration, advocating for additions to the national monitoring and evaluation strategies, minimizing biases in data collection through a “neutral third party,” gathering qualitative data in complement, and sharing implementation experiences

Scales to measure motivation among community health workers, and trust and empowerment among their clients: A guide

This How-To Guide presents five multi-item scales to measure motivation among community health workers (CHWs), as well as clients\u27 trust in CHWs, and empowerment within community health systems. The scales presented are intended for use in community health programs and in combination with other indicators in the CHW Performance Measurement Framework (published by the Frontline Health project in 2019) for routine data monitoring to improve quality and accountability in community health

Health data reporting challenges in Mopti, Mali: Results and implications from a mixed-methods study

This brief highlights results from the Frontline Health project\u27s mixed-methods study in Mali, conducted in partnership with the Aga Khan Foundation. The results indicate that community health workers (CHWs) in Mali face various challenges with data reporting and use, dissatisfaction with various aspects of their compensation, and little involvement in data use for decision-making, all of which may negatively impact their work motivation and satisfaction

Frontline Health: Harmonizing metrics, advancing evidence, accelerating policy—Project overview brief

Despite decades of technological and medical progress globally, half the world’s population still lacks access to essential health care due to insufficient numbers and types of health workers, especially in remote settings. There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care (PHC). Despite broad consensus on the importance of CHWs, few countries have successfully integrated them as part of PHC at scale, and many lack official statistics on the performance of CHW programs. USAID, UNICEF, and the Bill & Melinda Gates Foundation developed a Memorandum of Understanding to collaborate on investment priorities that advance frontline delivery of PHC and community engagement in health systems through the Integrating Community Health (ICH) partnership. The partnership aims to advance global learning around the integration of community-based service-delivery models in seven countries: Bangladesh, Democratic Republic of Congo, Haiti, Kenya, Liberia, Mali, and Uganda. As noted in this brief, embedded within the ICH partnership, the Frontline Health project is a three-year joint research, policy, and advocacy endeavor of the Population Council and Last Mile Health

Exploring community health worker roles, support, and experiences in the context of the COVID-19 pandemic in Bangladesh

This brief presents results from the Frontline Health project\u27s study in Bangladesh which explores CHWs\u27 perspectives and challenges providing support to their communities during COVID-19

Exploring community health worker roles, support, and experiences in the context of the COVID-19 pandemic in Kenya

This brief presents quantitative results from a mixed-methods study conducted by Population Council Kenya which explores the experiences and roles of community health workers (CHWs) during COVID-19. The results indicate that CHWs are carrying out their routine work at higher levels, with increased responsibilities due to COVID-19

Using evidence to advocate for the professional growth of community health workers in Bangladesh

This brief summarizes key findings from the Frontline Health project\u27s study in Bangladesh on community health worker (CHW) performance. The findings indicate that two cadres of CHWs—Family Welfare Assistants and Health Assistants—are highly trusted and valued in their communities, yet they face a myriad of challenges that affect their motivation and performance