Community health workers in low- and middle-income countries: What do we know about scaling up and sustainability?

S.W. Pallas, D. Minhas, R. Pérez-Escamilla, L. Taylor, L. Curry and E.H. Bradley

American Journal of Public Health, 2013, vol. 103, issue 7, e74-e82

Abstract: Objectives. We sought to provide a systematic review of the determinants of success in scaling up and sustaining community health worker (CHW) programs in low- and middle-income countries (LMICs). Methods. We searched 11 electronic databases for academic literature published through December 2010 (n = 603 articles). Two independent reviewers applied exclusion criteria to identify articles that provided empirical evidence about the scale-up or sustainability of CHW programs in LMICs, then extracted data from each article by using a standardized form. We analyzed the resulting data for determinants and themes through iterated categorization. Results. The final sample of articles (n = 19) present data on CHW programs in 16 countries. We identified 23 enabling factors and 15 barriers to scale-up and sustainability, which were grouped into 3 thematic categories: program design and management, community fit, and integration with the broader environment. Conclusions. Scaling up and sustaining CHW programs in LMICs requires effective program design and management, including adequate training, supervision, motivation, and funding; acceptability of the program to the communities served; and securing support for the program from political leaders and other health care providers. Copyright © 2012 by the American Public Health Association®.

Keywords: developing country; factual database; health auxiliary; health care quality; human; methodology; organization and management; poverty; program development; review, Community Health Workers; Databases, Factual; Developing Countries; Humans; Poverty; Program Development; Program Evaluation (search for similar items in EconPapers)
Date: 2013
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Citations: View citations in EconPapers (12)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.301102_7

DOI: 10.2105/AJPH.2012.301102

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