Les modules de formation des utilisateurs.

The global policy of providing primary level care was initiated with the declaration of Alma-Ata in 1978s. The countries signatory to Alma Ata declaration considered the establishment of CHW program as synonym with Primary Health Care approach (Mburu, 1994; Sringernyuang, Hongvivatana, & Pradabmuk, 1995). Thus, in many developing countries PHC approach was seen as a mass production activity for training CHWs in 1980s (Matomora, 1989). During these processes the voluntary health workers or CHWs were identified as the third workforce of “Human resource for Health” (Sein, 2006). Following this approach CHWs introduced to provide PHC in 1980s are still providing care in the remote and inaccessible parts of the world (WHO, 2006a). In this paper, we attempt to provide an overview of the concepts and practice of Community Health Workers (CHWs) from across a range of (developing and developed) countries, and draw some insights into policy challenges that remain in designing effective CHW schemes, particularly in the Indian context. In the subsequent sections, we provide a review of the various ways in which community health workers have been deployed in different settings. To arrive at this we adopted a systematic search of literature on CHWs, using key words such as community health worker, primary health care worker, community based health care worker, lay health worker, we also used the inclusion criteria that WHO adopted for describing CHWs (WHO, 2006a), in Pub-Med, Science Direct, WHO and World Bank sources. A total of 110 studies (including Journal articles, Reports etc are mentioned in the tables) were identified for this purpose. 

Prasad BM, Muraleedharan; August 2007

The global policy of providing primary level care was initiated with the declaration of Alma-Ata in 1978s. The countries signatory to Alma Ata declaration considered the establishment of CHW program as synonym with Primary Health Care approach (Mburu, 1994; Sringernyuang, Hongvivatana, & Pradabmuk, 1995). Thus, in many developing countries PHC approach was seen as a mass production activity for training CHWs in 1980s (Matomora, 1989). During these processes the voluntary health workers or CHWs were identified as the third workforce of “Human resource for Health” (Sein, 2006). Following this approach CHWs introduced to provide PHC in 1980s are still providing care in the remote and inaccessible parts of the world (WHO, 2006a). In this paper, we attempt to provide an overview of the concepts and practice of Community Health Workers (CHWs) from across a range of (developing and developed) countries, and draw some insights into policy challenges that remain in designing effective CHW schemes, particularly in the Indian context. In the subsequent sections, we provide a review of the various ways in which community health workers have been deployed in different settings. To arrive at this, we adopted a systematic search of literature on CHWs, using key words such as community health worker, primary health care worker, community based health care worker, lay health worker, we also used the inclusion criteria that WHO adopted for describing CHWs (WHO, 2006a), in Pub-Med, Science Direct, WHO and World Bank sources. A total of 110 studies (including Journal articles, Reports etc are mentioned in the tables) were identified for this purpose. 

Prasad B.,  Muraleedharan   August 2007

Lay health workers have no formal professional education, but they are usually provided with job-related training. They can be involved in either paid or voluntary care. They perform diverse functions related to health care delivery and a range of terms are used to describe them including village health workers, community volunteers and peer counselors among others. Growing concern regarding the human resource crisis in health care has renewed interest in the roles that lay health workers may play in primary and community care delivery.  This summary is based on a 2006 update of a Cochrane systematic review published in 2005 by Lewin et al. The summary focuses on the effects of lay health worker interventions in improving maternal and child health. The objective is to assess the effects of lay health worker (LHW) interventions in improving maternal and child health in low and middle-income countries.

 Xavier Bosch, Simon Lewin, Luis Gabriel, et al ; August 2008 

Policy makers face challenges to ensure an appropriate supply and distribution of trained health workers and to manage their performance in delivery of services, especially in countries with low and middle incomes. We aimed to identify all available policy options to address human resources for health in such countries, and to assess the effectiveness of these policy options. Quality health care depends on policies to ensure that health workers who are capable of delivering such care are available in sufficient numbers. Challenges related to human resources for health are particularly acute in countries with low and middle incomes. These challenges include an absolute shortage of qualified staff, especially in sub-Saharan Africa; an inequitable distribution of health workers, with too few in remote rural areas; and staff   absenteeism and poor motivation that are probably caused by low pay, poor supervision and support, and unsatisfactory working conditions. 

Mickey Chopra, Salla Munro  et al ; 2008