One of the biggest obstacles that healthcare providers face is how to reach patients in rural and economically depressed areas. Developing countries often don’t have enough healthcare facilities and providers to serve populations in these areas, and in developed countries, those who are poor or live in rural areas struggle to access the healthcare that is available.
In response, an increasing number of healthcare systems around the world are turning to the same solution: community health workers (CHWs). Researchers have observed that CHWs can have a significant positive impact on people’s health by providing education, supplies, and simple treatments that can prevent disease or cure common illnesses that could be debilitating or fatal if left untreated.
CHWs are not a new idea, but more healthcare leaders are recognizing their value and efficiency. Paul Farmer, the founding director of Partners In Health, told a peer-reviewed medical journal that if he had to recommend a single healthcare solution for people who live on less than $1 a day, he would choose CHWs. “If we train village health workers, and make sure they are compensated, then the resources intended for the world’s poorest […] would reach the intended beneficiaries,” he said.
CHWs are not doctors or nurses. Instead, they are people from a local community who are hired to visit patients in their homes and help them with simple health needs. Their work can range from providing mosquito nets to teaching patients personal hygiene. These steps toward patients managing their own care and preventing disease and illness make a lasting impact that transcend a single treatment or medicine.
Manmeet Kamur, a social entrepreneur who has led HIV prevention work in developing countries, recently told Politico that observing CHWs in South Africa and India showed her how effectively peers could take care of each other. “I was amazed,” she said.
History of CHWs
The concept of CHWs rose from necessity in some of the world’s most economically vulnerable communities, where residents had limited or no access to the few hospitals, clinics, and doctors. Healthcare workers observed that simple practices that could be done at home, such as handwashing, could significantly improve health.
In response, healthcare organizations began training people to do home visits and teach members of the community how to manage their own health. This was a better use of resources than sending more doctors and nurses into remote regions of developing countries, where people rarely see medical professionals.
Developing countries are fighting a never-ending battle to recruit more medical professionals, as even many of those trained in their home countries leave for better offers in the United States, Canada, or Australia. Those who remain often practice in cities, where patients are more likely to be able to pay for medical services.
Hiring people who already live in rural and economically depressed communities as CHWs provides much-needed jobs in these areas. When communities are healthier, people can work, go to school, and build better futures for themselves. A positive cycle can begin.
Studies of CHWs around the world have found that they work in the areas of preventative care, nutrition, and treatment to promote health and longevity for people of all ages. Here are some of their jobs:
– Set regular visits to patients who are terminally ill to assist with end-of-life care. In many cases, too, individuals who are prescribed daily medications are checked for compliance to assist in healthier lives and better outcomes.
– Refer people with severe mental illnesses to doctors or treatment facilities. Not only is there a stigma around mental health issues in some areas, people with severe mental illnesses are restrained or isolated. Like some developing countries, rural areas often have few mental health professionals, which naturally limits access and treatment options.
– Counsel people about healthcare options. People in rural communities often don’t know how to seek treatment for illness or disease. CHWs can talk to them about the cost of healthcare, transportation, and other issues surrounding their medical conditions.
– Provide invaluable insight for leaders shaping healthcare policy. CHWs know their communities and their patients well. Their observations and advice can significantly impact how healthcare is legislated and delivered in their areas.
– Help pregnant women and new mothers with common issues related to childbirth. CHWs who focus on women and children can provide simple yet important instruction on breastfeeding, nutrition for the child and mother, and immunizations. In some communities, infant mortality rates have dropped significantly when CHWs worked with new mothers.
Establishing a CWH program in a community isn’t easy. CHWs have to gain their community’s trust and respect for their work, which sometimes can take years. Additionally, they often have to overcome a community’s long-held beliefs, which can hinder people’s understanding of the importance of hygiene, good nutrition, and traditional healthcare.
When CWHs are effective, however, they can transform communities. With their assistance and input, healthcare professionals can create a cost-effective, custom healthcare system. CWH programs in India and South Africa have been so successful that some healthcare systems in the United States are adopting similar practices.