Module 6: Case Studies of Successful CHWs Models
Zambia: The Role of Lay Counselors in Combating HIV/AIDS(1)
According to recent estimates, 1.2 million out of a total population 10 million Zambians was infected with HIV by 2005. But like most African countries, there are not enough health workers to provide HIV counseling and testing services. In order to relieve the burden on the already overstrained health workers, community health workers were trained as lay counselors who could provide HIV counseling and testing services. A study indicates that their services are well-received at health facilities and they now provide up to 70% of the services. The study also reveals that the lay counselors are highly competent, their error rate being lower than that of health care workers themselves. Moreover, the quality of their counseling services was also high. Indeed, they are indispensable in resource-limited facilities. In conclusion, the study claims that “lay counselors, when provided with the approved and appropriate training, can play a key role in HIV counseling services. While they can support the provision of good-quality counseling and testing services to relieve overburdened health care workers, they will require ongoing supervision to further enhance their performance. In order to make this strategy sustainable, efforts must be made to mainstream their activities and formalize their relationship with the health facilities.”
Ethiopia: Health Extension Workers Fight Tuberculosis(2)
TB infects more than nine million per year, while killing two million lives annually. The disease burden is especially heavy in sub-Saharan Africa, where Ethiopia has the seventh highest TB infection rate in the world. One of the main ways of controlling the spread of TB is to identify and treat as many active sufferers of TB as possible. One of the main challenges has been locating such patients. In 2004, the government of Ethiopia started a health extension program (HEP) to train a new cadre of community level health workers to identify and treat TB sufferers preferably at an early stage to prevent the proliferation of this communicable disease. According to a recent study, the involvement of these health extension workers improved case detection and treatment success rates for TB in places with poor health service coverage in southern Ethiopia.
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Footnotes
(1) Adapted from Sanjana, Parsa, Kwasi Torpey, Alison Schwarzwalder, Caroline Simumba, Prisca Kasonde, Lameck Nyirenda, Paul Kapanda, Matilda Kakungu-Simpungwe, Mushota Kabaso and Catherine Thompson. "Task-shifting HIV counselling and testing services in Zambia: the role of lay counsellors." Human Resources for Health 30 May 2009 Web.12 Jun 2009. <http://www.human-resources-health.com/content/pdf/1478-4491-7-44.pdf>.
(2) Adapted from Datiko DG, Lindtjørn B (2009) Health Extension Workers Improve Tuberculosis Case Detection and Treatment Success in Southern Ethiopia: A Community Randomized Trial. PLoS ONE 4(5): e5443. doi:10.1371/journal.pone.0005443