28th February 2017
This month, the Community Health Worker Symposium in Kampala, Uganda, focussed on community health workers’ contribution towards the sustainable development goals. It included presentations from three HPI staff: Sally Findley, Andrew McKenzie, and Miniratu Soyoola.
The conference highlighted how Community Health Workers (CHWs) are now a key component of the health service and as such how their tasks have changed – for example, CHWs are now taking samples for tuberculosis diagnosis and implanting under-skin family planning devices. With this expanding role of CHWs, there is a stronger argument for reasonable payment, as occurs in Malawi and Ethiopia where CHWs already receive a salary and are included inside the formal health service.
The involvement of the private sector was another theme in the conference. Different presentations showed how CHWs and local drug stores could impact on their community’s health. For example, one presentation showed how CHWs could receive training, materials, and supervision to sell their services or drugs, contributing to a 27% reduction in UM5R. Other presentations also demonstrated the impact the private sector could have on diseases like diarrhoea, malaria, and pneumonia. However, a distinction was drawn between small private sector providers such as rural and urban drug stores, and large companies.
Sally Findley, a Professor of Population Health at the Mailman School of Public Health, who works for HPI’s Women For Health programme, gave presentations on: development of community health workers’ midwifery skills in northern Nigeria; HIV prevention methods involving community health workers; and the cost-effectiveness of alternative models using community health workers to promote maternal, newborn and child health.
Andrew McKenzie, a Technical Advisor for management capacity building on the Women for Health, Nigeria and Health Pooled Fund, South Sudan programmes, presented on increasing access to chronic HIV care, explaining the value of community health workers in models of differentiated care.
Miniratu Soyoola, the HPI Technical Adviser for Community Engagement, presented a paper entitled Scaling up the national Safe Motherhood Action Group initiative in Zambia. She outlined the work done by the More Mobilising Access to Maternal Health Services in Zambia Programme (MORE MAMaZ) to support the scale-up of a maternal and newborn health (MNH) community volunteer programme from 2014 to 2016. The programme supported the Zambian Ministry of Health’s Safe Motherhood Action Group initiative, which is key to the national safe motherhood policy response.
MORE MAMaZ intervention districts experienced increased health service utilisation, including: a 32% increase in skilled birth attendance rates; a 25% increase in institutional delivery rates; and a 14% increase in use of modern family planning. Communities reported significant reductions in gender-based violence and there was evidence of increased involvement of socially excluded women and girls. The presentation concluded by arguing that MORE MAMaZ generated robust evidence to demonstrate the effectiveness and impact of well-trained and supported safe motherhood community volunteers in Zambia. The programme also provided evidence of the possibilities of the national SMAG initiative if scaled up further.