This post originally appeared on the K4Health Blog.
The global shortage of health workers has created cracks in the bridge to health services for Africa’s communities. Many countries and donors are looking toward community health workers (CHWs), who have a vested interest in the health of their communities, to fill the gaps. Although CHWs have played a role in prevention and care for over 50 years, we have not had a way to evaluate whether the programs are meeting communities’ needs. We also don’t know the level of support CHWs receive to help them provide quality services.
It was this thinking that led Initiatives Inc. and the USAID-funded HCI Project to develop the Community Health Worker Assessment and Improvement Matrix (CHW AIM). Through a literature review and repeated testing, 15 components of a well-functioning program emerged, ranging from recruitment and training to community involvement and country ownership.
We designed the process to be used by program managers, CHWs, donors, and stakeholders. Led by a facilitator, the group engages in discussions about where they stand on each programmatic component on a scale from 0 (non-functional) to 3 (highly functional or best practice). In many cases, this is the first time ideas are shared from so many different perspectives. This can lead to awareness and sometimes confrontation, but the process also creates understanding and builds team spirit and commitment to improve. The group builds an action plan for the changes needed based on the assessment. Sue England of World Vision Australia observed, “The tools make it clear to all participants that we are assuming a lot and that’s why many programs fail.”