After a short break with the family, I am back trying to catch up on global health news. Of interest, the Lancet Global Health Network has a new International Health Journal with the Royal Society of Tropical Medicine and Hygiene.
In the first issue, there is an interesting article reviewing community participation in primary health care over the last 30 years. Interestingly, among the findings in the review, there is discussion about the strengths and weaknesses of using Community Health Workers (CHW) in primary care. Successful programs are those that are ‘driven, owned by and firmly embedded in communities themselves’.and ones that integrate health issues with other issues that afffect the lives of the community. This is compared to government run programs that use CHWs which then rely on public funding, supervision and maintenance for sustainability, resources which ultimately run out.
Thinking back to my previous blog entry, I used the Bangladesh family planning program as an example of a successful program, however, these issues of funding, and reliance on external support have made this model difficult to replicate.
My feeling is that soon ehealth solutions will address such things as training and supervision which can be done remotely. CHWs with mobile phones can text message the results of a days work, can escalate questions when the need arises and can attend online training programs to keep their knowledge and skills updated. Decision-making and technical support wil be provided to the CHWs while in the community and the resulting effeciencies will make the utilitization of CHWs more cost-effective and practical.