WHO

1. and WHO Global Health Workforce Alliance (GWHA)

2. WHY the Global Health Workforce Alliance (GHWA)? • A comprehensive response to the global human resources for health (HRH) crisis • Prompted by 3 consecutive WHA- generated resolutions (2004, 2005, 2006) to address various HRH issues • Helps accelerate the achievement of 2015 MDG Goals specifically MDGs 4 and 5

3. The Global Health Workforce Alliance(GHWA) 2006 2008 2010 2011 GHWA launched 1st Global Forum 2nd Global Forum Global CHW consultation

4. May 2006 GHWA launched • a convener • an open partnership • not a funding entity • board and a secretariat • litmus test of GHWA efforts: evidence

5. Human security approach to CHW Central government Top-down approach Protection Local government training, supervision & oversight, authorization, financing , logistics Community Health Committee selection of CHWs, identification of priorities Bottom-up approach Empowerment management, supervision & oversight participation OWNERSHIP motivation career advancement training mobilization Communities

6. April 2010 Global CHW consultation in Montreus, Switzerland Objectives 1. Review the recommendations of the global systematic reviews and 8 country case studies. Share experiences. Develop a broad agreement onkey messages for countries to integrate CHWs into their national health workforce.

7. Global systematic review • II. Case studies of country CHW Programs and program review in 8 countries (Pakistan, Bangladesh, Thailand, Ethiopia, Uganda, Mozambique, Brazil, Haiti) • applied HCI’s CHW assessment functionality tool • visited countries to interview key personnel overseeing the program • compiled information and reviews on programs (description, job descriptions, CHW roles) including evaluation reports and outcomes assessments

8. 13 Key Messages I. Planning, Production and Deployment (5) 1. Integrate CHWs fullyinto national HRH plans and health systems. 2. Involve key stakeholdersin the decision-making process. 3. Ensure effective and robust monitoring and evaluationthroughout the policy and implementation process or the scale-up of CHWs. 4. Any scale-up of CHWs has adequate supportincluding training, supervision, equipment and supplies, transport. 5. Existinghealth system should provide enabling environmentfor CHW policies and planned interventions.

9. II. Attraction and Retention (5) 6. Prepare and engage the communitythroughout the process. 7. Ensure a regular and sustainable stipendand, if possible, complement it with other rewards. 8. Ensure a positive practice environment. 9. Establish selection criteria, training duration, and scope of tasksthat are clearly stated, publicized and respected by all stakeholders. 10. Provide an ongoing continuing education for CHWsand, where possible, support opportunities for career advancement.

10. III. Performance Management (3) 11. Governments should take responsibility for the quality assurance of CHWs, even if CHWs are trained and managed by civil society or private not-for-profit groups. 12. Performance managementshould be based on a minimum set of need-based skills. 13. The management and supervision of CHWs should be team-based and development-focused, and integratedwith that of other health workers.

11. Summary and Key Points • CHWs are integral to health systems strengthening and overall global health; • Increasing services considered to be effective at the community level; • Global health initiative emphasizes linking CHWs to overall health system; and • Pressure is on governments and NGOs to provide support to CHWs in key areas, including incentives, supervision, standardized training, supplies. Source:Crigler L. Global Trends in CHW Programs. USAID-funded HCI Project 2010