Community health workers as bridge builders towards integrated care?

Abstract

In response to COVID-19 pandemic, which exacerbated the access to care challenges for people living in socio-economic vulnerable circumstances, the Belgian Federal Government gave the National Institute for Sickness and Disability Insurance (NIHDI) and the National InterMutualist College (Intermut) the task to introduce community health workers (CHWs) throughout Belgium. CHWs are “frontline public health worker[s] who [are] a trusted member of a community or who has a thorough understanding of the community being served. This relationship allows CHWs to serve as a link between health and social service programs and the community to promote access to services and improve the quality and cultural competence of service delivery” (Centers for Disease Control and Prevention, 2020: p. 50). They share a lived experience with people who live in vulnerable circumstances and are trusted members of local communities. CHWs can improve access to care for people living in vulnerable circumstances and make a valuable contribution to addressing the social determinants of health (Damio et al., 2017). They bring care closer to a patient, their household and community (Peretz et al., 2020, Perry and Hodgins, 2021).
 CHWs occupy a unique position between the community and the health system. This constitutes an essential advantage of their work, but it also demands that CHWs are both embedded in the community and have a functional relationship with actors in the health system (LeBan et al., 2021, Lewin et al., 2021, Perry et al., 2021, Schneider and Lehmann, 2016).
 This is a balancing act, which is an ongoing challenge today in various CHW programs world-wide, as well as in the Federal CHW project in Belgium. Lack of integration and synchronization between CHW programs and local health systems, risks to result in fragmented service delivery (Afzal et al., 2021). In this workshop we will explore together with the participants how to counteract this fragmentation and what the potential role of CHWs could be in integrated care?
 The workshop aims to integrate the vision of various participants: policy makers, researchers, clinicians, citizens, patients and caregivers who are interested in the potential of CHWs in integrated care.
 
 - Introduction (15 minutes): the workshop participants will receive an introduction into the Federal CHW project, framed in the global CHW landscape.
 - Presenting a case study (15 minutes): The role of the CHW in between the community and health system will be presented by different stakeholders involved: CHWs; the Health Kiosk as an example of community engagement; and primary health care providers.
 - Group work (20 minutes): The participants of the workshop will be invited to discuss the potential role of CHWs in integrated care and their embeddedness in the health system. The group will be divided in two smaller groups in which two themes will be discussed in-depth – facilitated by the workshop organizers.
 - Feedback & closing (10 minutes): the small groups will feedback to the plenary group with the most imminent discussion points of their discussion group. The take home message will then be summarized by the workshop organizers.