[Health volunteers--myth or reality? The preliminary elements of an evaluation of 9 years of experience in the Murialdo Community Health System, Rio Grande do Sul]

Community health workers programme in Luanda, Angola: an evaluation of the implementation process

BACKGROUND

The Community Health Workers (CHWs) Programme was launched in Luanda, Angola, in 2007 as an initiative of the provincial government. The aim of this study was to assess its implementation process.

METHODS

This is a case study with documental analysis, CHWs reports data, individual interviews and focus groups.

RESULTS

Until June 2009, the programme had placed in the community 2,548 trained CHWs, providing potential coverage for 261,357 families. Analysis of qualitative data suggested an association of CHWs with improvements in maternal and child access to health care, as well as an increase in the demand for health services, generating further need to improve service capacity. Nevertheless, critical points for programme sustainability were identified.

CONCLUSIONS

For continuity and scaling up, the programme needs medium- and long-term technical, political and financial support. The results of this study may be useful in strengthening and reformulating the planning of the CHWs programme in Luanda and in Angola. Moreover, the lessons learned with this experience can also provide insight for the development of CHWs programmes in other parts of the world. By means of cooperation, Brazil has supported the implementation of this CHWs programme and can potentially contribute to its improvement.

Effectiveness of community health workers in Brazil: a systematic review

The objective of this study is to assess the effectiveness of community health workers (CHWs) in Brazil. This systematic review included all studies that sought to assess interventions involving CHWs. Despite the low quality of evidence for most outcomes, analysis of the 23 publications included often found benefit for CHW intervention, best documented for frequency of child weighing, prevalence of breast-feeding, and delayed introduction of bottle-feeding. These findings and the current major role CHWs play in Brazil suggest that clarifying the benefit of CHW actions across a broad range of health care interventions should be a major research priority.