Examining community health workers’ role in fighting HIV in Africa

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Community health worker (CHW) programs can play a key role in providing HIV services in Africa. But such programs are often fragmented, poorly integrated into national health systems, and lack support, according to a new study from Harvard T.H. Chan School of Public Health.

The study was published Aug. 8, 2017 in PLOS Medicine.

Researchers interviewed government officials, expert observers, and donors in four African countries — Lesotho, Mozambique, South Africa, and Swaziland — between August 2015 and May 2016, and looked at published studies, country reports, national health plans, and policies. After analyzing all the data, they offered five policy recommendations to strengthen and sustain the role of CHWs in providing HIV services.

They recommended that decision-makers in countries where HIV is commonly found further develop government CHW programs; officially recognize nongovernmental CHW programs; standardize CHW training, incentives, and services; provide an organizational structure dedicated to community health initiatives; involve the community in decision-making; and provide adequate and long-term resources for CHW programs for HIV.

Lead author of the study was Harvard Chan School researcher Jan-Walter De Neve. Other Harvard Chan authors included Kathryn Andrews, Chantelle Boudreaux, Pascal Geldsetzer, Maria Vaikath, Till Bärnighausen, and Thomas Bossert.