Community health workers (CHW) – locally hired, community-based cadres quickly trained to deliver preventive and curative health services at the household level – are a critical component of the MVP health system model. The goal of the MVP CHW Program is to significantly reduce child and maternal mortality by delivering life-saving health interventions and creating a continuum of care from the household to the health facility. In the MVP context, CHWs are paid, secondary school graduates recruited from local community who are trained in a minimum set of core competencies, such as screening for danger signs and providing referrals for facility care when necessary, identifying and treating malaria, diarrhea, and pneumonia, and providing healthy behavior counseling. There are over 1000 CHWs in 11 MV sites across sub-Saharan Africa, deployed at a ratio of approximately 1 CHW for every 100-200 households depending on geography and population density.
While CHW programs come in all shapes and sizes, the MVP CHW Program has emphasized a paid, supervised, and professional cadre of CHWs for improved quality of services, accountability, and retention. The core principles that inform this system include professionalization, organizational management, innovation and technology, including mHealth, health system integration, and quality assurance.
In support of these core principles, with their emphasis on standardized training and robust supervision, the MVP CHW Program has developed a full package of training manuals, job aids, counseling, and other materials to support a professionalized CHW workforce equipped to provide standardized, quality health services at the household level. Drawing from international best practices as well as lessons learned in deploying and scaling CHW programs in the MVP, the toolkit provides CHW management with the resources necessary to:
- Train CHWs on the provision of maternal and child services and healthy behavior counseling, including case management of malaria, diarrhea, pneumonia in under-five children
- Train CHW supervisors on providing supportive supervision and mentoring to CHWs in the field
- Cost, advocate for, and deploy the CommCare mHealth platform in support of CHW workflows and data-informed program management
- Use data to improve CHW workforce management, program operations, and community health outcomes
- Train CHWs on Ebola surveillance and sensitization at the household levels
“How to Use and Maintain a Bednet” counseling card from the MVP CHW Training Package. Each counseling card includes an instructive image on the front, with key counseling messages written on the back.
The MVP CHW Training Package content reflects the range of management, mobile health, and process improvement systems developed by a team of health professionals, strategists, designers, and researchers throughout the lifespan of MVP. It is designed to be modular, so managers can select materials that fit their programs’ needs, and original files can be made available upon request for adaptation and localization of content. Tools such job aids and counseling cards are designed to support CHW training, as well as serve as reference tools to be used during household visits. The job aids, counseling cards, and Ebola sensitization resources are available in both English and French, with additional translations forthcoming.
The MVP CHW job aids outline protocols for home-based care provided by CHWs, including decision-making aids for identifying and treating malaria, diarrhea, and pneumonia.
Evidence has demonstrated that CHWs are critical to bridging the gap between households and clinics, bringing life-saving health services and behavior change counseling that improve community health outcomes and reduce mortality. We hope that the MVP CHW Training Package can support government, international, and NGO organizations as they design and deploy CHW programs for improved health coverage across the globe.