COMMUNITY HEALTH WORKER PROGRAMMING

Do NGOs need a principle of practice?

Core Group Fall Meeting October 11th -12th

Emerging Issues in CHW programmes

• Inappropriate reporting structures• Increased trust in NGOs as service providers• Mosaic training systems• Competitive working strategies• Diverse incentives amongst NGOs and project types• Parallel services and supply chain management • Quality & reporting diversity• Lack of consistent supervision systems• Grant based programmes versus long-term investments

Need for a Principle of Practice

• Call for a “Three ones” style approach to CHWs in health workforce crisis countries

• Eliminate the competitive working practices, without stifling creative approaches to delivery

• Establish minimum working standards and principles for NGOs engagement with CHWs within a country

• Framework on which to advocate for stronger country investment and leadership in community health

“Principles of practice” uses:

• Interagency statement on CHW engagement in health workforce crisis countries

• Recommendations for how iNGOs can partner with governments to deliver quality CHW programmes

• Series of recommendations to support policy and advocacy work

• Recommendations for individual programmes that will support the principles

Principle 1. Advocate for the legitimization and recognition of the CHW workforce within the formal health system through appropriate country policies and initiatives that support registration, accreditation and minimum standards for the role and performance of different cadres.

Principle 1. Advocate for the legitimization and recognition of the CHW workforce within the formal health system through appropriate country policies and initiatives that support registration, accreditation and minimum standards for the role and performance of different cadres.

Principle 2. Enable and support country leadership including national or regional coordination bodies empowered to provide oversight in CHW programme implementation across partner organizations and health authorities.

Principle 2. Enable and support country leadership including national or regional coordination bodies empowered to provide oversight in CHW programme implementation across partner organizations and health authorities.

Principle 3. Work with and through existing local health services and mechanisms to strengthen them, avoiding the creation of parallel CHW services, methods and supply chains or competitive working practices.

Principle 3. Work with and through existing local health services and mechanisms to strengthen them, avoiding the creation of parallel CHW services, methods and supply chains or competitive working practices.

Recommendations• One Country One Policy – across NGOs and different project types• Community Participation and Accountability• Non-payment of services• Only sustainable incentives schemes are implemented• Reasonable compensation • Performance based application of incentives • Non-financial incentives and advancement

Principle 4. Establish standards and methods for performance-based incentives systems which are ethical, non-competitive and sustainable, and under a unified country policy.

Principle 4. Establish standards and methods for performance-based incentives systems which are ethical, non-competitive and sustainable, and under a unified country policy.

Principle 5. Establish and agree on minimum standards for training of specific cadres of CHWs under an agreed unified system linked to performance-based accreditation.

Principle 5. Establish and agree on minimum standards for training of specific cadres of CHWs under an agreed unified system linked to performance-based accreditation.

Principle 6. Establish unified mechanisms for reporting and management of community health worker data that promote consistent quality monitoring, supervision and accountability to existing health structures and communities.

Principle 6. Establish unified mechanisms for reporting and management of community health worker data that promote consistent quality monitoring, supervision and accountability to existing health structures and communities.

Principle 7. Invest in appropriate low-tech innovations judiciously through partnership approaches which will enable improvements to CHW work according to their capacity, and are available within the public domain.

Principle 7. Invest in appropriate low-tech innovations judiciously through partnership approaches which will enable improvements to CHW work according to their capacity, and are available within the public domain.

Next steps

• Establish interest amongst Core Group members• Generate further discussion around the principles• Establish a working group for a potential interagency

piece

• Contact Polly Walker polly.walker@worldvision.org.uk • Shannon Downey sdowney@coregroupdc.org