COMMUNITY HEALTH WORKER PROGRAMMINGDo NGOs need a principle of practice? Core Group Fall Meeting October 11th -12th
Emerging Issues in CHW programmes• Inappropriate reporting structures• Increased trust in NGOs as service providers• Mosaic training systems• Competitive working strategies• Diverse incentives amongst NGOs and project types• Parallel services and supply chain management• Quality & reporting diversity• Lack of consistent supervision systems• Grant based programmes versus long-term investments
Need for a Principle of Practice• Call for a “Three ones” style approach to CHWs in health workforce crisis countries• Eliminate the competitive working practices, without stifling creative approaches to delivery• Establish minimum working standards and principles for NGOs engagement with CHWs within a country• Framework on which to advocate for stronger country investment and leadership in community health
“Principles of practice” uses:• Interagency statement on CHW engagement in health workforce crisis countries• Recommendations for how iNGOs can partner with governments to deliver quality CHW programmes• Series of recommendations to support policy and advocacy work• Recommendations for individual programmes that will support the principles
Principle 1.Advocate for the legitimization and recognitionof the CHW workforce within the formal healthsystem through appropriate country policies andinitiatives that support registration, accreditationand minimum standards for the role andperformance of different cadres.
Principle 2.Enable and support country leadership includingnational or regional coordination bodiesempowered to provide oversight in CHWprogramme implementation across partnerorganizations and health authorities.
Principle 3.Work with and through existing local healthservices and mechanisms to strengthen them,avoiding the creation of parallel CHW services,methods and supply chains or competitiveworking practices.
Principle 4.Establish standards and methods for performance-based incentives systems which are ethical, non-competitive and sustainable, and under a unifiedcountry policy. Recommendations • One Country One Policy – across NGOs and different project types • Community Participation and Accountability • Non-payment of services • Only sustainable incentives schemes are implemented • Reasonable compensation • Performance based application of incentives • Non-financial incentives and advancement
Principle 5.Establish and agree on minimum standards fortraining of specific cadres of CHWs under anagreed unified system linked to performance-based accreditation.
Principle 6.Establish unified mechanisms for reportingand management of community health workerdata that promote consistent quality monitoring,supervision and accountability to existing healthstructures and communities.
Principle 7.Invest in appropriate low-tech innovationsjudiciously through partnership approacheswhich will enable improvements to CHW workaccording to their capacity, and are availablewithin the public domain.
Next steps• Establish interest amongst Core Group members• Generate further discussion around the principles• Establish a working group for a potential interagency piece• Contact Polly Walker firstname.lastname@example.org• Shannon Downey email@example.com