Publications

    Ballard M, Madore A, Johnson A, et al. Concept Note: Community Health Workers. Harvard Business Publishing. 2018.Abstract

    Community health workers (CHWs)—lay people who engage in efforts to improve the health of their communities—have been proposed as a way to fill the global health human resource gap by extending services to hard-to-reach populations in remote areas. This concept note provides a brief history of CHWs, considers issues in CHW program design, and outlines future directions for research and funding.

    Visual Representation of CHW Density in Sub-Saharan Africa
    Visual representation of CHW density in Sub-Saharan Africa. Source: One Million CHWs Campaign, 2016.

    Learning objectives: This concept note aims to further students’ and instructors’ understanding of community health workers presented in the Cases in Global Health Delivery collection.

    Keywords: Human resources, primary care, disease management, monitoring and evaluation, resource allocation, global health policy, community health workers, partnerships

    Note: In map legend, 2,000–4,9999 should read 2,000–4,999.

    May M, Rhatigan J. BRAC’s Tuberculosis Program: Pioneering DOTS Treatment for TB in Rural Bangladesh. Harvard Business Publishing. 2011.Abstract

    This case examines the development of a tuberculosis (TB) treatment program in Bangladesh by the non-governmental organization, BRAC, from 1984 to 2006. After providing background about Bangladesh, the burden of TB there, and BRAC, the case examines how this program was piloted and grew to cover a population of 80 million people. It details how BRAC was able to create a TB control program that utilized community health workers to perform most of its essential functions including case finding, directly-observed therapy, identification of complications, and record keeping. The case concludes with a brief summary of BRAC’s expansion to Afghanistan and recently, Africa, and asks the reader to consider the feasibility of this TB care model in other contexts and in other conditions, such as HIV/AIDS.

    Teaching Note available through Harvard Business Publishing.

    Timeline of BRAC TB Program Expansions
    Timeline of BRAC TB Program Expansions. Source: From One to Many: Scaling Up Health Programs in Low-Income Countries. Edited by Richard A Cash, A Mushtaque R. Chowdhury, George B. Smith, and Faruque Ahmed (2010). Ch 13. Islam A and May MA. Decentralized Management in the Expansion of BRAC's Rural Tuberculosis Program (DOTS). Pgs. 207-214. (Exhibit 3 in "BRAC’s Tuberculosis Program: Pioneering DOTS Treatment for TB in Rural Bangladesh" case.)

    Learning Objectives: To understand effective strategies for effectively engaging community health workers to deliver complex medical and public health interventions to large populations in low resource settings.

    Supporting Content: The sequel to this case is titled Tuberculosis in Dhaka: BRAC’s Urban TB Program.

    Keywords: Community health workers, tuberculosis control, rural nongovernmental organizations, social enterprise