The role of 'hidden' community volunteers in community-based health service delivery platforms: Examples from sub-Saharan Africa

Natalie Leon, David Sanders, Wim Van Damme, Donela Besada, Emmanuelle Daviaud, Nicholas Oliphant, Rocio Berzal, John Mason, Tanya Doherty

    Research output: Contribution to journalArticlepeer-review

    27 Citations (Scopus)

    Abstract

    Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs), but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or 'hidden' community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the 'hidden' contribution of volunteers. We need to better characterize the volunteers' interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa.

    Original languageEnglish
    Article number27214
    Pages (from-to)Art: 27214
    Number of pages7
    JournalGlobal Health Action
    Volume8
    Issue number1
    DOIs
    Publication statusPublished - 2015

    Keywords

    • Child mortality
    • Community volunteers
    • Community-based care
    • Developing countries
    • Global health
    • Health systems
    • Population health
    • Sub-Saharan Africa

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