Community Response Theme: ‘Pathways to Health’ Health Workforce DCU Symposium

Summaries 

The committee received twelve submissions around the community response theme (please find the file of submissions below): 

• Community Health Workers:  The backbone of HIV services in Kenya’s urban slums
• Community Birth Attendants (CBAs) Still Have a Vital Role to Play
• A Systematic Review of the Effectiveness of Alternative Cadres in Community Based Rehabilitation
• Case histories of 13 PLHIV in Orissa State supporting fellow PLHIV
• Community Participation Promotes Swifter Community-Based Action
• PLHIV as Peer Counsellors in first level Health Care Facilities
• Maternity care systems and outcomes in Malawi: exploring traditional practices and practitioners
• Community Based Organisations for HIV care and support services
• Supporting & strengthening MNCH services using mobile phones: A research protocol
• mHealth Education: Harnessing the Mobile Revolution to Bridge the Health Education & Training Gap in Developing Countries
• Increasing Country & Community Involvement in Global Health Policy Processes: The Case of the Global Fund to Fight AIDS, Tuberculosis and Malaria
• Developing the roles community members as health advocates by community health workers. A report from the SODIS trial in Cambodia

Overview of Summaries 

Enida Friel, Oxfam provided an overview of the Community Responses Theme and the submitted materials.  Please find the presentation below along with the recording.   

Discussion

One group participated in a discussion around health workers and community responses.  This group was facilitated by Nadine Ferris France, IFGH and notes recorded by Aisling Walsh, RCSI.

Working Groups Feedback

Theme 1: Community responses

There were 12 submissions under this theme. The organizations that submitted were a mix of NGOs such as Trocaire, Concern (4), iheed and universities such as RCSI (3), TCD (2), DCU. The work presented covered a wide rage of countries such as Kenya, Malawi, Zimbabwe, Sierra Leone, Cambodia, Bangladesh (2), India, Haiti in a variety of settings such as urban (including urban slums) and rural. Research methodologies used also covered a combination of qualitative and quantities methodologies starting from case stories to cross sectional surveys, cohort studies, Randomised Controlled Trials (RCTs), systematic reviews, to in-depth interviews, focus groups, content analysis. Services covered included: HIV/AIDS; maternal, neonatal and child health (MNCH), community-based rehabilitation (CBR), food/water/shelter, health promotion/education.

The submissions fell mostly under three sub-themes: community health workers (CHW) (6), community and traditional systems, structures and organizations (4) and mobile phone applications for community health (2).

Community health workers

The type of CHWs covered by the submissions were for HIV/AIDS, MNCH, CBR. SODIS (solar disinfection of water). Some of the issues highlighted in the submissions included the importance of Health Care Workers in delivering quality health care, the need for training, support, supervision, motivation and payment of CHWs, and the potential for expansion of their role including for innovative health interventions though this is challenged by one submission on CBR.

Community and traditional systems, structures and organizations

The submissions under this sub-theme highlighted the importance of traditional practices and practitioners for maternity care and the role of community structures such as ward health committee in increasing access to other essential services such as for food, water and shelter at community level. The importance of continued support for community based organizations (CBOs) for sustainable community HIV responses was also highlighted by one submission while another one looked at the potential for increasing community involvement in global health policy and decision making processes through CBOs.

Mobile phone applications for community health

The submissions under this sub-theme documented the potential of mobile phones for delivering targeted counselling for pregnant women and children under 2 years of age, impacting on CHW motivation, training, supervision and knowledge retention and reducing cost of delivering health services. Some of the recommendations under this sub-theme included alignment of CHW to national human resources development plans, importance of coordinating and collaborating with other stakeholders and a call to move from ‘pilot’ models to implementation of scaled up proven interventions

Some of the questions deriving from the submissions that participants considered at group discussions were:

—  Integration of CHW into formal health system and national policy- is it possible and realistic?

—  Sustainability of CHW – how can it be ensured by NGOs, donors?

—  Should there be a renewed focus on Primary Health Care (PHC), prevention vs treatment?

—  Generic and simplified training content delivered through mobile phones- how can it be done?

—  What can the role of NGOs and academia is in all of the above?

Looking forward to the international conference planned on the same topic in February the participants expressed a desire to continue the discussion around community responses via on-line through IFGH, or another half to one day session, setting-up of a working group around the theme of community responses, invite more submissions and make en effort to bring more researchers, practitioners and policy makers from the South.

Enida Friel, Oxfam Ireland