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At least 19 recordsLinked to original sources
PubMed1997

Community health workers: who they are and what they do.

Community health workers (CHWs) are community members who serve as frontline health care professionals. They generally work with the underserved and are indigenous to the community in which they work-ethnically, linguistically, socioeconomically, and experientially. This article presents the results of a survey of 197 systematically selected health care providers in eight Bay Area counties. The authors found that 25% of the health care providers in these eight counties hire CHWs. The hiring projections indicate that opportunities are expanding for these frontline professionals; the majority of growth is in public health departments and community-based organizations. The majority of CHWs are women (66%) of color (77%) with a high school degree or less (58%). A total of 44% earn an annual salary of $20,00 to $25,000; 30% make more than $25,001. AIDS and maternal and child health are the two major content foci of CHW work.

California↗
PubMed2006

Measuring return on investment of outreach by community health workers.

Community health workers (CHWs) are effective in improving access to health care, promoting client knowledge and behavior change, and contributing to improved health status of individuals. However, few outreach programs have evaluated the financial impact of CHWs on health care systems and policies. A longitudinal repeated measures design was used to assess the return on investment (ROI) of outreach by CHWs employed by Denver Health Community Voices. Service utilization, charges and reimbursements for 590 underserved men were analyzed 9 months before and after interaction with a CHW. Primary and specialty care visits increased and urgent care, inpatient, and outpatient behavioral health care utilization decreased, resulting in a reduction of monthly uncompensated costs by $14,244. Program costs were $6,229 per month and the ROI was 2.28:1.00, a savings of $95,941 annually. These data provide evidence of economic contributions that CHWs make to a public safety net system and inform policy making regarding program sustainability.

Colorado↗
PubMed1994

Adults with acquired hearing loss: identification and referral patterns of community health workers.

Community health workers in one health region of New South Wales were surveyed about their criteria and referral patterns to identify and assist adults with acquired hearing losses. Reported or observed communication problems were the most commonly used criteria for identifying hearing loss, suggesting that a failure model was being utilised. Given that the literature has previously demonstrated reluctance on the part of individuals with acquired hearing loss to report their hearing difficulties, the implications of these results are discussed. Clients suspected of having acquired hearing losses were usually referred to their doctors for further investigation and treatment. Other hearing help services were not systematically utilised. Alternative strategies for identifying and managing acquired hearing loss at the community level are needed.

Community Health Workers↗
PubMed1998

Promoting health, promoting women: the construction of female and professional identities in the discourse of community health workers.

Community health worker (CHW) programs are implemented in the third world and among racial minorities in the U.S. by public health professionals with the goal of improving people's access to basic health services. There is a shared view that women's roles as mothers make them effective CHWs because most health practices are located within the realm of the family. The objective of this paper is to inquire how and what concepts of woman are constructed and promoted in CHW programs. Viewing CHW as a discourse, I examine literature on CHWs using a critical feminist perspective and insights from narrative and rhetorical analyses. I argue that CHW positions women living in the third world and non-white Hispanic women in the U.S. as the "other" woman. The natural attributes of this other woman include mother, care giver, oppressed, child-like, and victim of patriarchy, religion, poverty, and diseases. These attributes are used to define categories of the female such as "the third world woman" and "Hispanic woman". These categories, in turn, define two unnamed opposite categories: "the first world woman" and "the public health professional". I conclude that CHW is a colonizing discourse and that public health professionals and feminists need to practice reflexivity.

Caregivers↗
PubMed1997

Violence against women: an education program for rural community health workers.

This study aimed to identify the educational needs of community-based rural health professionals regarding violence against women, and was funded under the Rural Health Support, Education and Training (RHSET) program. Focus groups and teleconferences were conducted with health workers, organisations and key individuals in the Wide Bay Region, Queensland, Australia. As a result, an education package has been designed that will provide specific training in violence against women for rural and remote health professionals working in the field. Rural health community workers identified the need to enhance their intervention skills and understanding on the issue of violence against women. A distance education framework based on adult and guided learning principles has been developed to meet this need. Six areas were identified as important learning needs and included: (i) violence against women as a public health concern; (ii) The role of the community health worker; (iii) How the community health worker can empower women experiencing violence in their lives; (iv) Enhancing and developing supportive networks; (v) Building on community development action; and (vi) 'Where to next' for community health workers.

Adult↗
PubMed1987

Uncleanliness among persons seen by community health workers.

Community nurses and other community workers often encounter persons who live in conditions of extreme uncleanliness, but not much attention has been paid to the causes of this behavior. The author surveyed 12 community health centers in Sydney, Australia, to obtain data on specific aspects of personal and home cleanliness for persons under their care. Of the 83 subjects identified as living in unclean conditions, 15 were age 60 or younger. Almost two-thirds had some degree of memory impairment, and 40 percent were or had been heavy drinkers. However, 12 subjects did not have obvious physical or mental disorders, and the author suggests that eccentric personality factors may account for their living conditions. He believes uncleanliness should not be labeled as part of a syndrome, but that it is a sign that may lead to recognition of a causative disorder. He recommends further study of the problem.

Aged↗
PubMed1997

Detection and management of pneumonia by community health workers--a community intervention study in Rehri village, Pakistan.

This community based, case management intervention study was done to assess the effectiveness of Community Health Workers (CHWs) in case detection and management of pneumonia in children under five years of age. Twenty-two volunteers (school teachers and students) were selected as CHWs from Rehri village, in Sindh, Pakistan and trained on World Health Organization (WHO) recommended National/Acute Respiratory Tract Infection (ARI) guidelines at the Department of Paediatrics, Dow Medical College, Civil Hospital, Karachi. The CHWs had no prior health education. The intervention was the use of CHWs to detect and manage pneumonia in children under five years of age in Rehri village. Two medical officers supervised the post-training activities of CHWs in the village during the study period. Between December, 1992 and May, 1993, 442 episodes of pneumonia (very severe disease 10, severe pneumonia 54 and simple pneumonia 378) were detected and managed by trained CHWs. The medical officers agreed with the CHWs for classification and treatment in 356 (81%) cases. This study suggests that in areas where there is a shortage of trained health care professionals, educated community members such as school teachers can be trained to detect and manage pneumonia in their community.

Case Management↗
PubMed2004

Use of community health workers in research with ethnic minority women.

PURPOSE: To explore roles and effectiveness of community health workers in research with ethnic minority women in the United States (US). METHODS: Medline (1966-2002) and CINAHL (Cumulative Index to Nursing and Allied Health Literature; 1982-2002) databases were used to locate published research studies on the use of community health workers with ethnic minority women in the US. Key words for searches were community health workers, community health aides, health promoters, and community workers. RESULTS: An integrative analysis of 24 studies showed that, despite varying roles and functions, evidence indicates that community health workers are effective in increasing access to health services, increasing knowledge, and promoting behavior change among ethnic minority women. Other advantages of using community health workers are to provide social support and culturally competent, cost-effective care. Recommendations for future directions of research with community health workers and ethnic minority women include improved conceptualization of the community health worker role, theoretical frameworks for research designs, enhanced methods for evaluating effectiveness, and increased community involvement.

Clinical Competence↗
PubMed2006

On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru.

OBJECTIVE: To describe the profile of community health workers--health promoters, traditional birth attendants and traditional healers--in rural Quechua communities from Ayacucho, Peru. METHODS: Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. RESULTS: The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. CONCLUSION: It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

Journal Article↗
PubMed1994

A shotgun marriage--community health workers and government health services. Qualitative evaluation of a community health worker project in Khayelitsha.

In 1988 the Western Cape Regional Services Council (RSC) initiated a community health worker (CHW) project in Khayelitsha in order to extend its preventive services to people in the community and promote 'community upliftment'. An evaluation of this project was undertaken in 1991 and 1992 in order to examine the potential of this local health authority-run CHW project to be an appropriate primary health care model. Qualitative research methods were used to explore the nature of the work done by the CHWs, whether they were accepted in their communities, and whether the project functioned as part of an integrated health service infrastructure in Khayelitsha. The CHWs were found to provide the basis for a potentially effective, community-responsive service. However, several structural problems mitigated against this service. Relations between the CHWs and nurses in all the formal public health services in the area were superficial and fraught with problems. There were significant differences and conflicting policies between the RSC's CHW project and other neighbouring non-government CHW projects, and these posed various threats to both the RSC and the non-government projects. One of the most serious of these differences was that the RSC project had no structures or plans for community involvement in the running of the project. Before a CHW project is initiated, several critical issues need to be carefully considered and discussed with all the relevant stakeholders. Furthermore, CHWs need to be flexible, and accountable to the communities in which they work. Before employing CHWs, formal public health authorities need to consider carefully whether they are able to meet these criteria.

Community Health Services↗
PubMed2004

CHWs get credit: a 10-year history of the first college-credit certificate for community health workers in the United States.

Community health workers have become increasingly important in the U.S. health care system, playing a significant role in basic health promotion and care coordination; however, their status and visibility have not kept pace with their wider use. A major impediment has been the absence of systematic preparation-the field needs standardized education in programs that emphasize the actual skills and knowledge used by community health workers, programs that attract and retain nontraditional students from underserved communities and that foster professional advancement. This article chronicles the 10-year history of the first college credit-bearing community health worker certificate program in the country to address this need. Systematic research resulted in a program centered on the core competencies universally practiced by community health workers regardless of their topical focus. The certificate program combines performance-based methods with popular education into an innovative pedagogical approach that teaches skills, while solidifying, contextualizing, and enhancing crucial experiential knowledge. Program outcomes validate the approach.

California↗
PubMed1995

The clinical competency of community health workers in the eastern highlands province of Papua New Guinea.

A case study of the clinical competency of community health workers employed in the Eastern Highlands Province of Papua New Guinea was conducted in March 1993. Of the 79 who graduated from the Onamuga Community Health Worker Training School between 1989 and 1992, only 24 were currently employed in the province. Current knowledge and clinical competency were compared with results on completion of basic community health worker training. Results showed that 22 of the 24 maintained their knowledge competency, and 15 maintained clinical competency. It was found that those community health workers (CHWs) employed at a health subcentre use 40% to 50% of their skills, whilst those at a district health centre or provincial hospital use only 20% to 30% of their skills. Only 8% of the CHWs studied used all the skills obtained in their basic training. This study indicates that the CHW is being viewed by some health managers as a replacement for the nurse aide. If CHWs' skills are to be maintained, certainly good supervision, inservice training and adequate logistic support are needed, but so also is a change in management thinking. The CHW has been trained specifically to improve the access to essential primary health care services of people living in rural areas, especially in preventive and maternal and child health care. If in practice the CHW is not given the opportunity to practise and hence maintain these skills, the whole logic of the CHW training scheme will need to be reexamined.

Adult↗
PubMed1988

Diagnosis and management of dysentery by community health workers.

To develop guidelines for community health workers in the treatment of patients with diarrhoea, diarrhoea prevalence was actively surveyed for a year in a remote rural community of 915,000 persons, and the enteric pathogens and clinical features associated with diarrhoeal illness were determined in a sample of 300 patients. Bloody diarrhoea accounted for 39% of all diarrhoea episodes and 62% of diarrhoea-associated deaths. 51 (50%) of 101 patients with a history of bloody diarrhoea had Shigella infection, compared with 31 (16%) of 199 patients with other types of diarrhoea. A history of bloody diarrhoea was as predictive of the presence of shigella infection (positive predictive value 50%, negative predictive value 86%) as more complex prediction schemes incorporating other clinical features or stool microscopic examination. In the area of Bangladesh where the study was done reduction of diarrhoea-related morbidity and mortality will depend on control and treatment of shigellosis, and community health workers have been instructed to provide antibiotics for patients with a history of bloody dysentery.

Anti-Infective Agents, Urinary↗