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Improving Community Health Worker Programs

The CHW AIM Matrix assesses, improves, and guides community health worker programs towards best practices. It contributes to a strategic approach, provides practical tools, and builds local capacity. Examples of field applications and baseline results are outlined, showcasing the benefits of this toolkit. Partnerships and timelines for implementation are detailed along with the advantages and objectives of the CHW AIM Matrix. CHW Central, a resource hub, aims to support ministries of health, NGOs, donors, and agencies in improving CHW programs. Launching in early 2011.

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Improving Community Health Worker Programs

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  1. Improving Community Health Worker Programs

  2. HCI’s CHW Program Improvement Work • CHW AIM (The Community Health Worker Assessment and Improvement Matrix) • CHW AIM Operations Research Zambia • CHW Central

  3. Overarching Concerns • Respond to global needs to strengthen systems to support CHW programs • Contribute to a more strategic approach to CHW program implementation • Provide practical tools to disseminate and reinforce best practices • Build local capacity to assess and improve CHW programs in relationship to best practices

  4. CHW AIM (CHW Program Assessment and Improvement Matrix) A tool and process that guide self-directed assessments of CHW programs and an action planning process. Responds to recognized need to strengthen systems to support CHW programs • Pepfar II: HSS and increase of health workers • GHI: HSS, integration and sustainability • WHO/Global Health Workforce Alliance: country-level support and expansion of CHW programs

  5. CHW AIM Objectives • Assess program functionality, identify strengths and areas of need, and guide improvement using a simple process and clear criteria that can be applied across projects/programs • Assess health service interventions • Facilitate action planning to guide improvements

  6. CHW AIM Approach Self and group assessment, using criteria consistent with WHO/GHI, of 15 key areas and health service interventions: Community Involvement Referral System Opportunity for Advancement Documentation, Information Management Linkages to Health System Program Performance Evaluation Country Ownership • Recruitment • CHW Role • Initial Training • Continuing Training • Equipment and Supplies • Supervision • CHW Performance Evaluation • Incentives • Health service interventions in MNCH, HIV, TB, Water/Sanitation (TBD), RH (TBD)

  7. CHW AIM Example Section

  8. The CHW AIM Field Applications • Field tests in Nepal and Benin • Salvation Army in Zambia applied the CHW AIM to assess the Chikankata Child Survival Project • WHO GHWA 8 country case studies on CHW Programs • Save the Children in Ethiopia assessed vCHWs and HEWs • CHW AIM OR: 2-year comparative study in Zambia with 5 partners to assess impact of applying CHW AIM as an improvement framework

  9. WHO Results Country Case Studies NOTE: For a minimally functional program  a score of at least 2 is required in each of the 12 components

  10. Field Test Results NOTE: For a minimally functional program  a score of at least 2 is required

  11. CHW AIM OR Objectives: • To test the effectiveness of the CHW AIM toolkit as a capacity building and performance improvement tool. • To test the theory that strengthening CHW program functionality leads to improved CHW engagement and performance. • To assess the costs associated with implementing the CHW AIM tool and the incremental cost effectiveness associated with its use.

  12. CHW AIM OR Timeline: 2 years – July 2010 to June 2012 Partners: World Vision, Salvation Army, ZPCT Project/FHI, CHAZ/Coptic Mission Hospital, mothers2mothers Sample: 5 CHW programs and 130 CHWs, one control (30 CHWs) Tools: CHW AIM, CHW engagement survey, CHW engagement interview, program management interview, performance assessments

  13. CHW AIM OR Baseline Results NOTE: For a minimally functional program  a score of at least 2 is required

  14. CHW AIM OR Baseline Results

  15. CHW AIM Advantages • Both quantitative (scoring and counting) and qualitative (interviews and discussion) • Can be applied at a country level to assess multiple programs or at the individual level • Provides clear criteria across programs for multiple partners/implementers • Can be complemented by other tools • Matrix can be applied without the workshop through interviews and document discovery (eg., GHWA 8 country case studies, Ethiopia)

  16. CHW Central Description: A website to house resources related to community health worker programs Rationale: To provide evidence-based resources and a central community for CHW programs Audience: Ministries of health, NGOs, donors, technical support agencies Contents: Training materials, practical tools, guidelines, best practices, blog, virtual learning sessions, interactive discussions, downloadable resources Timeline: To be Launched in early 2011

  17. CHW Central • Brief • Seeking inputs and feedback from the community

  18. Other Related Work • CHW Productivity Assessment • CHW Collaboratives

  19. THANK YOU

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