Decolonizing Global Health: Increasing Capacity of Community Health Worker Programs

Abstract

Many global health volunteer experiences and research projects are focused on the needs of the host country participants, which perpetuates a sovereign or superior relationship towards low- or middle-income countries (LMIC). The purpose of this paper is to discuss ethical and culturally sensitive practices in LMIC when providing health care as a volunteer or researcher. International ethical standards for providing global health care are discussed. The author participated in a volunteer global health experience for three months in Kenya. An evaluation of a nongovernmental organization (NGO)-sponsored community health worker (CHW) program was conducted and is presented here. Health indicators such as prenatal care visits, birth attendance by skilled personnel, and full vaccination of children improved by 34%, 36%, and 24%, respectively, following 5 years of implementation of the CHW program. Global health care can be provided in a more socially responsible and sustainable manner by supporting NGO-sponsored CHW programs affiliated with local ministries of health in LMICs.