A PACT health promoter meets with a patient in her home
(image courtesy Partners In Health)
Nurses and community health workers provide the vast majority of health care services around the world. However, training and education, scope of practice, compensation, and much more vary widely amongst and between nurses and CHWs. There is also very little formally known about their working relationships, best practices or effects on patient outcomes.
To address these important questions, GHDonline has organized a virtual Expert Panel discussion, “Nurses and CHWs Working Together“, taking place this week in the Global Health Nursing and Midwifery Community.
“Making sure that nurses feel confident and comfortable with task sharing with newly minted CHWs is critical,” says Dr. Heidi Behforouz, Founder and Executive Director of the Prevention and Access to Care and Treatment (PACT) project, part of Partners In Health in Boston, Massachusetts. To build this level of confidence, PACT devotes additional time to training nurses on working with Community Health Workers (CHWs) and providing programmatic and clinical supervision. PACT also works with leadership to ensure nurses have protected time to manage and teach CHW colleagues.
Please join Dr. Behforouz and other panelists, including Sarah Nunn, RN, MSN, health promoters Carolina Lopez Ochoa and Albany Chavarria from Teach for Health, in sharing additional examples of nurses and CHWs working together and discussing strategies for strengthening these relationships to improve care delivery.
As always, we look forward to your questions and contributions during this GHDonline Expert Panel!
Maggie Sullivan, GHDonline Global Health Nursing & Midwifery Moderator, contributed to this post.
In my country CHWs are called CHVs to certify their act of voluntarism. Government, through the Ministry of Health policy on gCHVs does not allow for payment of incentives/compensation to gCHVs.This lack of identified mean of motivation has led to lack of commitment of CHVs and poor working relationship between them and the paid health workers.
As part of our Ministry of Health decentralization policy on health, the County Health and Social Welfare Team (CH& SWT) and partners are encouraged to identify and develop strategy (ies) for motivation of CHVs/CHWs. These strategies include but not limited to inclusion of CHVs in immunization campaigns, workshop and other health related activities to receive incentives.
To improve the working relationship between not only nurses in particular but health workers in general and the CHVs, we health workers must change our mindset about CHVs. We must view them key structures in the health care delivery system that is based at the community. They must therefore be interpreted as partners and not just ordinary group of people.
Health workers must realize their moral responsibility of providing quality health care to beneficiaries within their operational areas as is the case with Merlin-Zwedru and Tiyatien Health in Grand Gedeh, Liberia, for and with whom we work.
In order to derive maximum outcomes from services provided, CHVs/CHWs must be empowered by health workers ensure increased utilization of health care services. This empowerment can be achieved through training, workshop and regular meetings.
Supervision and monitoring of the CHVs/CHWs and services they provide is another key component of empowerment ad support which is crucial in fostering good working relationship between the two groups. Health workers must allocate time within their work plan to conduct regular supervision and monitoring exercises of this important community structure within their operational areas as mean of providing support and thus improve their quality of work.
Finally, health workers must initiate the holding of regular meetings with the CHWs/CHVs to discuss freely, assessing progress of work, identifying gaps and to jointly developing strategies to bridge the gaps.This attitude generates in the CHWs/CHVs a sense of belonging and collective responsibility for ensuring their communities receive quality health care services.