The Role of Community Health Workers in a Fragmented Health System


Tyrell Junius
@tysmoothshoota
The Role of Community Health Workers in a...

Rural health development across the world is approaching a paradigm shift for accessing quality health services and seamless payment structures. Technology is closing the health information gap for people who are furthest from receiving healthcare. However, the digital divide disparity for rural citizens of the world who lack sufficient broadband connection fail to reach a doctor when they need it most. What can we do? During a recent webinar series promoting universal health coverage (UHC) held by Amref Health Group, Professor Miriam Khamadi Were, Chancellor at Moi University stated, “If it’s not happening in the community, it’s not happening.” This is where the digital divide starts. Nearly 60% of the world’s population is not connected to the internet, says a World Bank Group Report of the digital divide. Similarities between health system designs between developed countries and emerging economies like (AMEA, APAC, & Latin America) primarily benefit people who are connected to quality information and payment structures in majority urban/metropolitan areas. But what about those who are not connected?

Demographic shifts with the world’s youngest (majority Africa) and oldest populations (majority Asia & Western countries) are not aware of recent advances to access health services. This demographic dividend is coupled with a world shortage of clinical professionals. Not to mention, how many recent medical school graduates do you know are willing to work in a rural area where the need is highest? Strong structural reforms are needed to empower medical professionals to work where need is evident. If not, why not amplify efforts on preventative health measures? This is where community health workers (CHWs) can have imminent profound impact. Community Health Workers (CHWs) are viewed as the frontline soldiers of our healthcare system. CHWs are responsible for assisting nurses, environmental specialists, midwives, doctors, health administrators, companies and non-governmental organizations (NGOs) for delivering quality health information to their catchment populations in a timely fashion.

We cannot depend on our governments alone to solve our healthcare problems, what collective impact approaches are private and public sector companies using to strengthen people systems?

Have you heard of Collective Impact?

According to the Rural Broadband Strategy spearheaded by Microsoft, connecting rural areas to new opportunities, numerous recommendations are proposed how to spur investment and work with public sector organizations to optimize analog technologies. However, this is a small leap towards understanding a much larger problem. Stated in one Stanford Social Innovation Review article, “Large-scale social change requires broad cross-sector coordination.” Encouragingly enough, recently the world has witnessed the new joint venture between Amazon, Berkshire Hathaway, and JPMorgan Chase that shows some promise of how the private sector can get involved and deliver new models of care for all. In the meantime, while juggernauts figure out the best approach, what can communities do today to develop holistic models of care?

Social Supply Chains of Digital Health

Policy trends are gravitating towards achieving UHC targets and aligning with the UN Sustainable Development Goals (SDGs) by 2030. Hello, this is only 12 years away and I’m afraid our world leaders have developed tunnel vision. A more dynamic and cross cutting approach is needed to accelerate community engagement models and sectoral collaboration. Imagine vertically integrated partnership models between socially responsible organizations in IT, agriculture, retail, academia, and manufacturing. Each partner playing a distinct clear role and all visions are aligned for social good. For example, what can the MapMyFitness app have in common with health providers, farmers, retail stores, or public health offices? From a nutrition perspective, farmers and nutritionists can work together to deliver tailored meal plans. Retail stores can create clothes and products that fit all cultures and body sizes.

Using a mix of technology and basic person to person interaction, an IT platform can streamline user experiences and feedback that can contribute to reducing stress of government health expenditure around the world. Community centered care is possible if we train our health system on prevention tools and allocate more resources for CHWs to obtain relevant skills and knowledge to deliver preventative care information.

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  • Dr Bonface FUNDAFUNDA

    Thanks for an enlightening article, elevating the role of the CHW. With increasing recognition of the importance of IT in public service, we have a small, but significant step change to make, in how public health services are provided. Consider the fact, too, that many governments (significantly in Africa), have national development policies and strategies that include inclusion and use of IT tools to enhance services. With that commitment in place, it now a question of accessing systems, and implementation.

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    • Tyrell Junius

      Thanks Dr. Fundafunda for sharing your insight. I believe private sector players are beginning to align some initiatives to government. However, private sector stakeholders may continue to be single minded until they receive some type of incentive for everyone to access systems and quality health services using technology.

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  • Tyrell L Junius

    Thanks Dr. Fundafunda for sharing your insight. I believe private sector players are beginning to align some initiatives to government. However, private sector stakeholders may continue to be single minded until they receive some type of incentive for everyone to access systems and quality health services using technology.

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