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.

Strengthening HIV linkage and retention through improved community/facility collaboration in Palla Road, Botswana

This ASSIST case study describes how the community improvement team in Palla Road village worked with facility staff to figure out how to leverage existing community platforms and resources to locate patients who were lost to follow-up (...

Using Collaborative Improvement to Enhance Postpartum Family Planning in Niger

The report describes the ASSIST project intervention in 16 facilities in Niger that led to an improvement in postpartum family planning (PPFP) quality and uptake, and adherence with selected FP methods of choice. The intervention, which...

Quality improvement— a game changer for Kenya

Bill Okaka

Knowledge Management & Communications Officer, ASSIST Kenya

After the promulgation of the Kenyan constitution in 2010, the Right to Health by all Kenyans cannot be refuted. Fatuma Abdullahi, a practicing nurse, is the institutional memory of the unfolding of events in the northern frontier semi-arid regions of Kenya. Her three decades of facility and community work has been characterized by:

  • low utilization of health services (even in situations where access wasn’t a problem due to short distances)
  • high neonatal and maternal mortality (the region scores a Maternal Mortality Ratio of 790/ 100,000 live birth), and
  • low financial resource ploughing by national and county governments (compared to resource envelop received vis-à-vis the vastness of the region).

Integrating Nutrition Services in HIV and TB Care in Mindolo I Clinic in Kitwe, Zambia

With support from the United States Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), health care workers in Kitwe District are improving the quality of nutrition assessment,...

The Mixed Nature of Incentives of Community Health Workers: Lessons from a Qualitative Study in Two Districts in India

This article, published in Frontiers in Public Health, examines the role that incentives play in motivating community health workers (CHWs) and in family dynamics that affect CHW performance. In India, accredited social health activists (...

USAID ASSIST Project Annual Performance Monitoring Report FY15

This annual report for the USAID ASSIST Project summarizes the project's accomplishments and results in FY15 supporting the application of modern improvement methods by host country providers and managers in USAID-assisted countries...

Increasing institutional deliveries through improving community-facility linkages in Mewat, Haryana State, India

Empowering communities and frontline health workers to use quality improvement (QI) methods to achieve better antenatal and intrapartum care, the USAID ASSIST Project supported a community QI team in Mewat, Haryana. The team observed that...

Partnership for HIV-Free Survival Community Demonstration Project in Gaza, Mozambique

Beginning in late 2013, the USAID ASSIST Project began to provide technical support for community-level improvement of elimination of mother-to-child transmission (EMTCT) services to the Ministry of Health of Mozambique as part of the...

Strengthening Community Health Systems to Improve Health Care at the Community Level

Communities play a key role in the continuum of care as they can increase access to care by spreading health promotion messages, contributing to case identification, referring to facilities, and following up patients. Much of a patient’s...

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