Abstract
BackgroundThe need to scale up treatment for HIV/AIDS has led to a revival in community health workers to help alleviate the health human resource crisis in sub-Saharan Africa. Community health workers have been employed in Mozambique since the 1970s, performing disparate and fragmented activities, with mixed results.MethodsA participant-observer description of the evolution of community health worker support to the health services in Angónia district, Mozambique.ResultsAn integrated community health team approach, established jointly by the Ministry of Health and Médecins Sans Frontières in 2007, has improved accountability, relevance, and geographical access for basic health services.ConclusionThe community health team has several advantages over 'disease-specific' community health worker approaches in terms of accountability, acceptability, and expanded access to care.
Highlights
Sub-Saharan Africa faces a dire shortage of human resources for health, a situation exacerbated by the overwhelming demands of the dual epidemics of HIV/AIDS and tuberculosis (TB) that have swept over the region [1]
This paper provides a participant-observer perspective of the evolution of Community health workers (CHWs) from vertical and isolated activities for TB, HIV and other specific diseases to an integrated community health team approach for tackling the main disease burden in a rural district of Mozambique
At the end of 2007, 38 groups were active in the district, providing the following services for members: sharing of information and experiences during monthly meetings; obtaining ARVs for those who could not attend their consultations at health centre level; tracing of defaulters; and social support
Summary
Sub-Saharan Africa faces a dire shortage of human resources for health, a situation exacerbated by the overwhelming demands of the dual epidemics of HIV/AIDS and tuberculosis (TB) that have swept over the region [1]. At the end of 2007, 38 groups were active in the district, providing the following services for members: sharing of information and experiences during monthly meetings; obtaining ARVs for those who could not attend their consultations at health centre level; tracing of defaulters; and social support (through collective fields or gardening). These groups are highly motivated and function on an independent basis and receive only occasional support from counsellors on technical issues. Their activities are limited to just a few hours per week in order to allow them to engage in other work
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