Community Health

Community Health System

As the complex needs of people facing the double burden of health issues and socio-economic difficulties are increasingly identified and addressed, the importance of community-level health and social services is magnified. Improvement methods can be applied at the community level to address the quality and coverage of health and social welfare services, strengthen linkages between the community and the health system, and enhance the capacity of existing groups and networks to affect health issues in their own communities. 

A particular area of focus for improvement in community health is to strengthen the effectiveness and sustainability of programs that rely on community health workers (CHWs). Due to large catchment areas and numbers of households they are expected to cover, CHWs are frequently inadequate to provide services to all households needing them.  Although CHWs are usually linked to facilities, facility health care teams often do not have the time or capacity to address the challenges facing CHWs. Leveraging existing networks and indigenous structures to work together to improve the health of community members can improve CHWs’ acceptance, morale, and performance.

MaNHEP Change Package for Improving Community Support Processes for Maternal and Newborn Health

In close collaboration with the Federal Ministry of Health (FMoH), Regional Health Bureaus (RHB), Zonal Health Departments (ZHD) and Woreda Health Offices (WorHO), the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) has worked...

An interview with Dr. Ram Shrestha:Supporting Community Health Workers- Where do we stand?

Rhea Bright

Quality Improvement & Human Resources for Health Advisor, USAID Bureau for Global Health Office of Health Systems

In this post, Rhea Bright interviews Dr. Ram Shrestha.

As a health professional, whenever I visit a rural village in a low-or middle-income country, several thoughts come to mind. Knowing that the formal health system usually ends at a health center, dispensary, or health post in these rural communities, does everyone in this village have access to health services? How can we ensure that there are enough health workers in nearby facilities to provide needed services? Are there community health workers (CHWs) in this village, and are they well supported? I started thinking more and more about these questions as World Health Worker Week (April 7-11, 2014) approached…consequently even more questions came to mind.

Using mHealth to Improve the Performance and Engagement of Village Health Teams

Emily Lanford


A component of Uganda’s national strategy since 2001, Village Health Teams (VHTs) serve as an initial point of health system contact for much of the country’s population.  Unfortunately, the number of available VHTs and the scope of their duties are not sufficient to reach all households needing services.  Further exacerbating the problem is that Uganda is plagued by grave disparities between the number of patients requiring medical care and the number of available doctors able to provide those services (the ratio is estimated to be 1:24,000 by the World Health Organization).  

Giving hope: A story on how community networks support persons living with HIV/AIDS

Mabel Namwabira


The USAID ASSIST Project and Uganda’s Ministry of Health supported a project to improve the quality of chronic care services in 10 villages in Buikwe district from June 2012. This followed an assessment at 14 health facilities in September 2011 which revealed minimal community support for HIV/AIDS patients. At one health facility in Buikwe district in May 2012, over 90 People Living with HIV (PLHIV) had dropped out of care for more than 3 months. Out of 90, only 10 were traced due to incorrect contact information given by PLHIV to their care providers.

MaNHEP Learning Sessions

This document summaries the experience of the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) in conducting learning sessions. The guide summaries how MaNHEP used learning sessions to facilitate learning between sites and...

A Global Improvement Framework for Health Worker In-service Training: Guidance for Improved Effectiveness, Efficiency and Sustainability

This short report describes the improvement framework for in-service training programs that was developed by the USAID Health Care Improvement Project in collaboration with key stakeholders. In-service training (IST) represents a...

MaNHEP Coaching Materials

This document is a compilation of coaching materials developed for the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) to provide training and tools for coaches as they supported community-level teams. The materials include...

Focusing on the person, not the problem

Nigel Livesley

Regional Director for South Asia, USAID Applying Science to Strengthen and Improve Health Systems (ASSIST) Project, University Research Co., LLC (URC)

I really like this case study by Tiwonge Moyo because it highlights the importance of focusing on the person not on the problem.  Many aid projects come in with a set of solutions for specific problems.  For example, education projects may give school materials to improve education or nutrition/livelihood projects may provide animals to improve economic security.  The needs of people and communities, though, are usually more complex and single solutions may not always work. 

A community-led approach to improve early childhood development (ECD) and nutrition in Blantyre District, Malawi using quality improvement methods

With support from the United States Agency for International Development, a community in the Blantyre District of Malawi managed to increase the number of children aged 3-6 years old attending community based childcare centers (CBCCs) from...