A systematic review of existing reviews on community health workers, Improvements in malaria testing and treatment after a national community health worker program in rural Liberia, Rwanda optimistic about latest breakthrough in search for a malaria vaccine, Evaluating vertical malaria community health worker programs as malaria declines: learning from program evaluations in Honduras and Lao PDR, Continuity of community-based healthcare provision during COVID-19: a multi-country interrupted time series analysis. Based on Terror Management Theory (TMT), the present research examined whether a close relationships defense mechanism reduces anxiety among healthcare workers (N=729) in China. In Liberia, for example, 45% of malaria cases are treated by CHWs; in Rwanda 56%.24,25 Such levels of contribution by CHWs have been noted in other countries.26, Recent evidence from 27 districts across 4 countries in sub-Saharan Africa (Kenya, Mali, Malawi, Uganda) found that CHWs supported in line with the WHO Guidelines (i.e., paid, equipped, and continuously trained) and protected with adequate PPE were able to maintain speed and coverage of community-delivered care during the pandemic.27 Specifically, there were no disruptions to the coverage of proactive household visits or iCCM assessments or to the speed with which iCCM was delivered, pregnancies were registered, and postnatal care was received. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-21-00648. Large disruptions in health care utilization occurred as a result of the COVID-19 pandemic and endured for many months.22 How do we maintain essential health services in crisis and ensure strong systems are capable of responding to changing care-seeking behaviors as a result of fear of facility-based transmission? Investing in community health workers (CHWs) and community-based organizations can help address the social determinants of poor health that disproportionately affect low-income, minority populations and that are magnified during times of crisis, the trio wrote. That created total cost savings of $19 million annually across a single care network. This is different from what a clinical provider can offer, the three argued. Medical workers perceived less vulnerable to infection showed stronger defense. One official described this change as a dream for the Ministry of Health for the last 20 yearsreinforcing the notion that crises present opportunities for landmark policy change.41. Why Community Health Partnership is Key to Drive Health Equity, NIH Funds Research into Community Health Worker Training, Community Health Partnerships Key to Address Health Via Housing, Citizen Status, Household Size Tied to COVID-19 Health Disparities. READ MORE: Community Health Partnerships Key to Address Health Via Housing, In collaboration with community-based organizations, CHW teams proactively contacted socially isolated patients, connecting them with sources of critically important care and support, Peretz, Islam, and Matiz stated. MOHs can explain the complex funding landscape of multilateral, bilateral, philanthropic, and national investments; they will identify key gaps, funding priorities, and trusted implementing partners. The coronavirus disease (COVID-19) pandemic reminds us that CHWs who are equipped, trained, and paid as part of a well-functioning health system can help keep pandemics in check and maintain health services equity and access. This evidence suggests that the opportunity cost of not professionalizing CHWs may be substantially larger than previously estimated in light of the inevitability of future pandemics.32. CHWs cannot be supported to respond to pandemics or maintain essential services unless MOHs know who and where they are. By dispensing with ways of working that hinder CHW institutionalization and professionalization, resilient health systems are within our grasp. These healthcare workers also serve as patient advocates and patient navigators. New philanthropic investments should align with and support government strategies according to their needs and changing circumstances, including the demands of civil society. This kind of success wasnt new for Peretz, Islam, and Matiz, they wrote. N Rise, The Role of Community Health Workers in the COVID-19 Response in the Caribbean, an exploratory study, European Journal of Public Health, Volume 31, Issue Supplement_3, October 2021, ckab164.349, https://doi.org/10.1093/eurpub/ckab164.349. Cite this article as: Ballard M, Johnson A, Mwanza I, et al. Global crises present opportunities for landmark policy changes. This can help maintain patient access to care, in addition to alerting health systems to the community health efforts they may consider putting forth. As with all accredited professionals, CHWs must be meaningfully included in decision making and represented on bodies that plan their work and working conditions. Give CHWs the benefits they deserve including hazard pay, family leave, compensation for overtime, and sick leave. Working with MOHs to strengthen community health provision ensures that we are all better prepared to face future pandemics. The use of community health workers (CHWs) during the COVID-19 response is key to engaging communities and strengthening their capacity to limit the spread of disease. CHWsif equipped with ongoing training, supervision, remuneration, medical commodities, and personal protective equipment (PPE)can prevent, detect, and respond to pandemics by carrying out tasks as diverse as leading community-based infection prevention and control, facilitating safe sample collection, conducting contact tracing, accelerating vaccination roll-out, and providing home-based care to those in quarantine (Table 1).320, Examples of How CHWs Have Prevented, Detected, and Responded to Pandemics. Practices that hinder CHW stability, support, and labor rights can be intentionally replaced with those that enable sovereign, resilient health systems to flourish. 2022 Creative Commons Attribution 4.0 International License. To expand, improve, and institutionalize these services, changes in the approach to bi/multilateral aid and private philanthropic investments in low- and middle-income countries are required. These findings extend TMT by identifying two moderating variables: vulnerability and social support. Despite the important work clinicians do and that work was on full display in New York at the head of the coronavirus crisis community health workers have lived experiences that allow them to develop trust with patients and deliver practice advice, Peretz, Islam, and Matiz said. By dispensing with ways of working that hinder CHW institutionalization and professionalization, resilient health systems are within our grasp. Community health workers are medical professionals who operate in a non-clinical capacity. True pandemic preparedness and response requires global health actors to accelerate the shift from practices that cause harm to practices that accelerate impact. PatientEngagementHIT.com is published by Xtelligent Healthcare Media a division of TechTarget. Further, healthcare workers with higher levels of social support reported more relationship satisfaction. https://doi.org/10.9745/GHSP-D-21-00648, This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. Testimonials from MOH officials indicate this quick action helped both countries kickstart their response (Charles Mwansambo and Sylvia Chila, video communication, November 2020). Their organizations had been employing community health workers for some fifteen years. The Role of Mobile Engagement: Insights from a new 2022 Healthcare Executive Survey, Webcast Executive Summary: How Payer Digital Transformation Improves Provider and Member Satisfaction, 9 Principles of Digital Patient Engagement Success, Top Challenges Impacting Patient Access to Healthcare. A systematic review, Effects of community health worker interventions on socioeconomic inequities in maternal and newborn health in low-income and middle-income countries: a mixed-methods systematic review, Stock-outs of essential medicines among community health workers (CHWs) in low-and middle-income countries (LMICs): a systematic literature review of the extent, reasons, and consequences. Then we must do much more, much better. Institutionalize minimum practice standards to ensure CHWs possess the knowledge and competencies required to deliver quality patient care, build trust, and help formally acknowledge the key role CHWs in many cases already play. All rights reserved. Relation between the food environment and oral healthsystematic review, Latent class trajectories of socioeconomic position over four time points and mortality: the Uppsala Birth Cohort Study, Extreme heat leads to short- and long-term food insecurity with serious consequences for health, Change in effectiveness of mammography screening with decreasing breast cancer mortality: a population-based study, Burden of cardiovascular diseases and depression attributable to psychosocial work exposures in 28 European countries, About The European Journal of Public Health, About the European Public Health Association, https://doi.org/10.1093/eurpub/ckab164.349, https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model, 5.F. Table 2 provides additional, though not exhaustive, examples of harmful practices and more promising alternatives for a wide spectrum of funder types and roles.4447 These examples paint a picture of dynamics that have hindered the current response and can be reversed before the next pandemic. Community Health Workers in Pandemics: Evidence and Investment Implications, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, Community Health Acceleration Partnership, Protecting Community Health Workers: PPE Needs and Recommendations for Policy Action, Prevent, detect, respond: rapidly expanding healthcare teams through community health workers in the fight against COVID-19, Community health workers champion Kenya's COVID-19 response, Community health workers and pandemic preparedness: current and prospective roles, Use of a community-led prevention strategy to enhance behavioral changes towards Ebola virus disease prevention: a qualitative case study in Western Cte d'Ivoire, World Health Organization (WHO) and UNICEF, The Role of Community Health Workers in COVID-19 Vaccination: Implementation Support Guide, 26 April 2021, Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception, Contraceptive injections by community health workers in Uganda: a nonrandomized community trial, PIH Guide. We believe that CHW programs should be carefully designed, offer adequate training and ongoing supervision of workers, and be integrated into stable systems with sustainable funding, Peretz, Islam, and Matiz concluded. Community health workers are key for engaging and supporting communities and vulnerable populations during the COVID-19 pandemic. READ MORE: NIH Funds Research into Community Health Worker Training. And as healthcare sets its sights on a landscape post-pandemic, it will have to accept the way COVID-19 has left its mark. Preprint, Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations, Urgent immunisation campaign launched in 13 counties to tackle polio outbreak, Second round of polio immunisation campaign underway in 13 counties, to prevent childhood disease, Community Health Worker Assessment and Improvement Matrix (CHW AIM) Updated Program Functionality Matrix for Optimizing Community Health Programs, WHO Guideline on Health Policy and System Support to Optimize Community Health Worker Programmes, Implementation Support Guide: Development of a National Georeferenced Community Health Worker Master List Hosted in a Registry, User Guide for the Community Health Worker Coverage and Capacity Tool, Turning a short-term crisis into long-term change, Govt to give allowances to village health teams, Compensation models for community health workers: comparison of legal frameworks across five countries, What is the Risk Pool Fund? To achieve resilient health systems, bi/multilateral aid and private philanthropies need to review their investment practices to replace those that cause harm (high transaction costs, earmarking, short-termism, appropriation of sovereignty) with practices that ensure timely and effective implementation of priorities set by government stakeholders (pooling, longer commitments, and alignment with evidence-based guidelines). Provided that, Peretz, Islam, and Matiz asserted that community health workers are well poised to meet healthcares most current problems: COVID-19 and a reckoning with racial health disparities and health inequities. In particular, these funds should be deployed rapidly and flexibly against government-set priorities. COVID-19 has exposed and exacerbated systemic inequalities, the sharp focus on which has diminished tolerance for inequality and catalyzed louder demands to dismantle inequitable systems. Community health workers (CHWs)people trained to meet the health needs of their communities by delivering care in their communitieshave been a critical part of health care delivery across diverse contexts for over a century.1 They have also been woefully under-supported: recent estimates suggest that across the African continent, more than 4 in 5 CHWs are unpaid.2 In the context of increasing global health insecurity and a burgeoning health workforce crisis, this trend must change. CHWs should be paid at a competitive rate relative to the respective market and paid consistently, on time, and commensurate with the job. Lessons learned on community health workers during the COVID-19 pandemic should be integrated into health policies to strengthen the health workforce and improve sanitary emergency preparedness. Search for other works by this author on: The Author(s) 2021. Ministry of Health (MOH), Guidance For Implementing Home Care of People Not Requiring Hospitalization For Corona Virus Disease (COVID-19). This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (. The campaign was a success. To that end, payers and providers should begin to invest in a strong community health workforce, they asserted. However, few formal policies on the work of CHWs are available. One example of this type of government-led funding is the Community Health Roadmap Catalytic Fund, a unique fund designed to meet small-scale, flexible funding needs that are prioritized by community health coordinating mechanisms within MOHs.39 In this crisis, this fund supported the MOH COVID-19 response at the community level in Malawi and Zambia, getting funds to governments before large funding resources were available.