Community health workers in Ghana: the need for greater policy attention.
Identifieur interne : 000152 ( PubMed/Checkpoint ); précédent : 000151; suivant : 000153Community health workers in Ghana: the need for greater policy attention.
Auteurs : Leonard Baatiema [Ghana] ; Anthony Mwinkaara Sumah [Ghana] ; Prosper Naazumah Tang [Ghana] ; John Kuumuori Ganle [Ghana]Source :
- BMJ global health [ 2059-7908 ] ; 2016.
Abstract
From the 1970s to the 1990s, the WHO, United Nations and other agencies mooted the idea of formally training and recognising community health workers (CHWs) to complement efforts to improve primary healthcare delivery in low and middle income countries. Recently, CHWs have been recognised as important players in the achievement of the health-related Millennium Development Goals (MDGs). Despite this recognition, little understanding exists in Ghana about the activities of CHWs: who they are; how they are recruited; what they do; level of health policy support; contribution to healthcare delivery and the challenges they face. Based on a rapid scoping review of the existing literature, and our experience working in Ghana, this paper reflects on the role of CHWs in healthcare delivery in Ghana. We argue that CHWs have played critical roles in improving health service delivery and outcomes, including guinea worm eradication, expanded immunisation coverage, maternal and child health, and HIV/AIDS treatment and management. However, these achievements notwithstanding, CHWs face challenges which prevent them from being optimally productive, including capacity problems, neglect by the healthcare system, high attrition rates and inadequate supervision. Policymakers in Ghana therefore need to give increased attention to CHWs, provide remuneration for their activities, create career opportunities and other means of motivations to boost their productivity and sustain gains associated with their activities.
DOI: 10.1136/bmjgh-2016-000141
PubMed: 28588981
Affiliations:
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greater policy attention.</title><author><name sortKey="Baatiema, Leonard" sort="Baatiema, Leonard" uniqKey="Baatiema L" first="Leonard" last="Baatiema">Leonard Baatiema</name><affiliation wicri:level="1"><nlm:affiliation>Integrated Social Development Centre, Tamale, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Integrated Social Development Centre, Tamale</wicri:regionArea><wicri:noRegion>Tamale</wicri:noRegion></affiliation></author><author><name sortKey="Sumah, Anthony Mwinkaara" sort="Sumah, Anthony Mwinkaara" uniqKey="Sumah A" first="Anthony Mwinkaara" last="Sumah">Anthony Mwinkaara Sumah</name><affiliation wicri:level="1"><nlm:affiliation>Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Ghana Health Service, Upper West Regional Health Directorate, Wa</wicri:regionArea><wicri:noRegion>Wa</wicri:noRegion></affiliation></author><author><name sortKey="Tang, Prosper Naazumah" sort="Tang, Prosper Naazumah" uniqKey="Tang P" first="Prosper Naazumah" last="Tang">Prosper Naazumah Tang</name><affiliation wicri:level="1"><nlm:affiliation>Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Ghana Health Service, Upper West Regional Health Directorate, Wa</wicri:regionArea><wicri:noRegion>Wa</wicri:noRegion></affiliation></author><author><name sortKey="Ganle, John Kuumuori" sort="Ganle, John Kuumuori" uniqKey="Ganle J" first="John Kuumuori" last="Ganle">John Kuumuori Ganle</name><affiliation wicri:level="4"><nlm:affiliation>School of Public Health, University of Ghana, Accra, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author></analytic><series><title level="j">BMJ global health</title><idno type="ISSN">2059-7908</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">From the 1970s to the 1990s, the WHO, United Nations and other agencies mooted the idea of formally training and recognising community health workers (CHWs) to complement efforts to improve primary healthcare delivery in low and middle income countries. Recently, CHWs have been recognised as important players in the achievement of the health-related Millennium Development Goals (MDGs). Despite this recognition, little understanding exists in Ghana about the activities of CHWs: who they are; how they are recruited; what they do; level of health policy support; contribution to healthcare delivery and the challenges they face. Based on a rapid scoping review of the existing literature, and our experience working in Ghana, this paper reflects on the role of CHWs in healthcare delivery in Ghana. We argue that CHWs have played critical roles in improving health service delivery and outcomes, including guinea worm eradication, expanded immunisation coverage, maternal and child health, and HIV/AIDS treatment and management. However, these achievements notwithstanding, CHWs face challenges which prevent them from being optimally productive, including capacity problems, neglect by the healthcare system, high attrition rates and inadequate supervision. Policymakers in Ghana therefore need to give increased attention to CHWs, provide remuneration for their activities, create career opportunities and other means of motivations to boost their productivity and sustain gains associated with their activities.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">28588981</PMID><DateCreated><Year>2017</Year><Month>06</Month><Day>07</Day></DateCreated><DateRevised><Year>2017</Year><Month>08</Month><Day>16</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2059-7908</ISSN><JournalIssue CitedMedium="Print"><Volume>1</Volume><Issue>4</Issue><PubDate><Year>2016</Year><Month>Nov</Month></PubDate></JournalIssue><Title>BMJ global health</Title><ISOAbbreviation>BMJ Glob Health</ISOAbbreviation></Journal><ArticleTitle>Community health workers in Ghana: the need for greater policy attention.</ArticleTitle><Pagination><MedlinePgn>e000141</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmjgh-2016-000141</ELocationID><Abstract><AbstractText>From the 1970s to the 1990s, the WHO, United Nations and other agencies mooted the idea of formally training and recognising community health workers (CHWs) to complement efforts to improve primary healthcare delivery in low and middle income countries. Recently, CHWs have been recognised as important players in the achievement of the health-related Millennium Development Goals (MDGs). Despite this recognition, little understanding exists in Ghana about the activities of CHWs: who they are; how they are recruited; what they do; level of health policy support; contribution to healthcare delivery and the challenges they face. Based on a rapid scoping review of the existing literature, and our experience working in Ghana, this paper reflects on the role of CHWs in healthcare delivery in Ghana. We argue that CHWs have played critical roles in improving health service delivery and outcomes, including guinea worm eradication, expanded immunisation coverage, maternal and child health, and HIV/AIDS treatment and management. However, these achievements notwithstanding, CHWs face challenges which prevent them from being optimally productive, including capacity problems, neglect by the healthcare system, high attrition rates and inadequate supervision. Policymakers in Ghana therefore need to give increased attention to CHWs, provide remuneration for their activities, create career opportunities and other means of motivations to boost their productivity and sustain gains associated with their activities.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Baatiema</LastName><ForeName>Leonard</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Integrated Social Development Centre, Tamale, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculty of Health Sciences, School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sumah</LastName><ForeName>Anthony Mwinkaara</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tang</LastName><ForeName>Prosper Naazumah</ForeName><Initials>PN</Initials><AffiliationInfo><Affiliation>Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ganle</LastName><ForeName>John Kuumuori</ForeName><Initials>JK</Initials><AffiliationInfo><Affiliation>School of Public Health, University of Ghana, Accra, Ghana.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>12</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Glob Health</MedlineTA><NlmUniqueID>101685275</NlmUniqueID><ISSNLinking>2059-7908</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Hum Resour Health. 2009 Jul 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Version="1">23541538</PMID></CommentsCorrections></CommentsCorrectionsList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>07</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>10</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>11</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>6</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>6</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>6</Month><Day>8</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28588981</ArticleId><ArticleId 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