Community health workers, village health workers, lay health workers, these are all terms that describe similar roles and the literature has much to say about them. I want to summarize, in a several part series, what the literature says about community health workers and their effectiveness.
Today, in 2008, there is renewed energy about primary care and community health workers and there is wide-spread acceptance that they have the potential to make significant improvements in the health of individuals and communities, but there is also growing literature indicating that there are effective and less effective ways to use community health workers.
First, what are community health workers (CHWs) or village health workers?
Most common definitions of CHWs define them as members of the community with limited training to provide basic health and nutrition services. They usually work part time as health workers and may be paid or volunteer, however they are not usually civil servants or professionally employed by a ministry of health.
In what specific areas has the work of CHWs been found to be most effective?
Studies have show these benefits of CHWs:
- increase vaccination rates
- improve health in people with lung infections
- improve health in people with malaria
- increase breastfeeding
- decrease death in the elderly
- reduction in neonatal mortality
- improvement in neonatal care
- reduction in child mortality
- management of pneumonia and malaria
- improved community and personal hygiene
- improved diarrhea management
- effective treatment of HIV/AIDS and TB
Community health workers also bring with them benefits that are sometimes difficult to quantify in a study. Dr. Paul Farmer calls community-based care the highest standard of care. His organization's website, Partners in Health, states, "By improving adherence to treatment, monitoring medical and socioeconomic needs, empowering patients, and reducing the risk of hospital-acquired infections, community health workers make possible a model of comprehensive, community-based care that is the highest standard of care available anywhere."
But, what makes community health workers effective and what are the potential problems that need to be addressed? These will be taken up in the following posts.