Mapping and analysing community health worker programmes in the Eastern Mediterranean region

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES

International Journal of Health Planning and Management Pub Date : 2024-02-10 DOI:10.1002/hpm.3772

Uta Lehmann, Gulin Gedik, Arooj Jalal

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引用次数: 0

Abstract

Background

Community health worker (CHW) programmes are increasingly being recognized as an important strategy that can help to strengthen comprehensive primary health care (PHC), as the foundation of work towards achieving universal health care (UHC) and meeting the Sustainable Development Goals (SDGs). The WHO Regional Office for the Eastern Mediterranean undertook a situational analysis of CHW programmes in the Region to better understand the current situation and the issues involved.

Methods

A two-step process was employed: a review of available literature on CHWs in the Region was conducted, followed by a survey of CHW programmes in the region, focussing on programmes that were country-led and country-wide.

Results

Thirteen countries were found to have community health worker programmes with varying governance and programmatic structures. Broadly, two categories can be distinguished: (a) several countries have well established and mature national CHW programmes that are in most cases supported by external donors but driven and coordinated by national governments; (b) a greater number of countries that have smaller, emerging government or partner led projects and programmes. A few countries have deliberately opted for other models to strengthen primary care and community outreach, for example, through community nursing.

Conclusion

CHW programmes play an increasingly important role in primary health care in the Eastern Mediterranean Region, providing promotive, preventive, and emergency services. This bodes well for efforts to strengthen and embed comprehensive primary health care as the foundation of national health systems, to improve health emergency preparedness, achieve UHC and meet the SDGs. Nonetheless, all but a few programmes face challenges of weak governance, fragmentation and unreliable support, similar to those in other countries. However, the main finding of the analysis was that the role of CHWs in countries' health service delivery is woefully under-researched in almost all countries in the region, and more research to better understand and support programmes in the context of local health system contexts is urgently needed.

Abstract Image

查看原文本刊更多论文

绘制和分析东地中海地区的社区保健工作者计划。

背景：社区保健员（CHW）计划日益被视为有助于加强全面初级卫生保健（PHC）的重要战略，是实现全民卫生保健（UHC）和可持续发展目标（SDGs）的基础。世卫组织东地中海地区办事处对该地区的社区保健工作者计划进行了情况分析，以更好地了解现状和相关问题：方法：分两步进行：首先对该地区有关社区保健工作者的现有文献进行审查，然后对该地区的社区保健工作者计划进行调查，重点是国家领导的和全国范围的计划：结果：发现有 13 个国家实施了社区保健员计划，其管理和计划结构各不相同。大体上可以分为两类：(a) 一些国家拥有完善成熟的国家社区保健员计划，这些计划在大多数情况下得到外部捐助者的支持，但由国家政府推动和协调；(b) 更多的国家拥有规模较小的新兴政府或合作伙伴领导的项目和计划。少数国家有意选择其他模式来加强初级保健和社区外联，例如通过社区护理：结论：社区保健工作者计划在东地中海地区的初级保健中发挥着越来越重要的作用，提供促进、预防和紧急服务。这预示着，加强和嵌入综合初级卫生保健作为国家卫生系统的基础，改善卫生应急准备，实现全民健康和可持续发展目标的努力将大有可为。然而，除少数计划外，所有计划都面临着治理薄弱、各自为政和支持不可靠等挑战，这与其他国家的情况类似。然而，分析的主要发现是，该地区几乎所有国家都对社区保健工作者在国家卫生服务提供中的作用研究严重不足，迫切需要开展更多研究，以更好地了解和支持符合当地卫生系统背景的计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Health Planning and Management Multiple-

CiteScore

4.50

自引率

3.70%

发文量

197

期刊介绍： Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.