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Health policy and system support to optimise community health worker programmes: an abridged WHO guideline

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Cometto, Giorgio, Ford, Nathan, Pfaffman-Zambruni, Jerome, Akl, Elie A, Lehmann, Uta, McPake, Barbara, Ballard, Madeleine, Kok, Maryse, Najafizada, Maisam, Olaniran, Abimbola, Ajuebor, Onyema, Perry, Henry B, Scott, Kerry, Albers, Bianca, Shlonsky, Aron and Taylor, David (2018) 'Health policy and system support to optimise community health worker programmes: an abridged WHO guideline'. Lancet Global Health, Vol 6, Issue 12, e1397-e1404.

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Abstract

Optimising community health worker (CHW) programmes requires evidence-based policies on their education,
deployment, and management. This guideline aims to inform efforts by planners, policy makers, and managers to
improve CHW programmes as part of an integrated approach to strengthen primary health care and health systems.
The development of this guideline followed the standard WHO approach to developing global guidelines. We
conducted one overview of reviews, 15 systematic reviews (each one on a specific policy question), and a survey of
stakeholders’ views on the acceptability and feasibility of the interventions under consideration. We assessed the
quality of systematic reviews using the AMSTAR tool, and the certainty of the evidence using the GRADE methodology.
The overview of reviews identified 122 eligible articles and the systematic reviews identified 137 eligible primary
studies. The stakeholder perception survey obtained inputs from 96 respondents. Recommendations were developed
in the areas of CHW selection, preservice education, certification, supervision, remuneration and career advancement,
planning, community embeddedness, and health system support. These are the first evidence-based global guidelines
for health policy and system support to optimise community health worker programmes. Key considerations for
implementation include the need to define the role of CHWs in relation to other health workers and plan for the
health workforce as a whole rather than by specific occupational groups; appropriately integrate CHW programmes
into the general health system and existing community systems; and ensure internal coherence and consistency
across different policies and programmes affecting CHWs.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 21 Medicine as a profession.
W General Medicine. Health Professions > Professional practice > W88 Administrative work. Teaching. Research
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1016/S2214-109X(18)30482-0
Depositing User: Stacy Murtagh
Date Deposited: 23 Nov 2018 13:52
Last Modified: 23 Nov 2018 16:39
URI: https://archive.lstmed.ac.uk/id/eprint/9661

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