Friday, April 13th, 2018
Lassana Jabateh, Director of Community Health Programs for PIH Liberia (at right in white shirt), stands with CHW supervisors in Malawi during a PIH cross-site collaboration and learning trip. Photo by Dan Palazuelos / Partners In Health
When community health worker (CHW) programs have focused on supporting patients with pre-defined conditions, the impact for these patients can be life-changing. Community-based accompaniment provided by Partners In Health CHWs in Haiti and Peru more than a decade ago, for example, resulted in game-changing outcomes in HIV and TB care that were felt around the world.
As it turns out, that’s just the start of what CHWs can do.
At PIH sites in Malawi and Liberia, a transition is underway to a new model that recognizes CHWs’ value extends far beyond the needs of any specific patient group. More than just a link to other levels of the health system, CHWs can be agents of social connection. When CHWs are able to work with all households in a community instead of only with patients known to be sick, it can have dramatic implications.
— Lassana Jabateh, Director of Community Health Programs for PIH Liberia
The CHW household model can reduce stigma because having a CHW visit the home is no longer associated with having a disease. As CHWs provide a wide variety of services across maternal and child heath and communicable and non-communicable diseases, they also help respective governments achieve health-related targets in the Sustainable Development Goals. CHWs chosen by their community and trained by PIH can also help facilitate broader changes on a community level because everyone in a community can be involved and take part in the same discussions.
Lassana Jabateh (Liberia) and Benson Chabwera (Malawi) look over the sputum collection boxes being given to each CHW supervisor after that day's training. Photo by Dan Palazuelos / Partners In Health
“PIH Liberia is one of PIH's newest sites and PIH-Malawi is 11 years old, yet when watching the two teams come together for the first time, it was like watching a family reunion,” said Dr. Dan Palazuelos, Senior Health and Policy Advisor for Community Health Systems at Partners In Health. “They understood each other immediately and had a working relationship almost instantaneously. It was heartening to watch.”
Zayzay Lavela, Julia Rogers, Lassana Jabateh (Liberia) join Sam Msiska, Victor Kanyema (Malawi) to visit Loveness Dona and her family during as assessment for social support (as part of the Program on Social and Economic Rights (POSER). Photo by Dan Palazuelos / Partners In Health
“The Liberian team suggested that we try using a more comprehensive approach to accompanying pregnant women that includes helping them to come up with practical ways of preparing for delivery and possibly post-natal processes,” Nhlema said. “Our CHWs can help pregnant women to plan together with their families on how they will support the pregnant woman throughout pregnancy, delivery period and afterwards, and the CHW can monitor on a monthly basis how that plan is being ‘actionalized’ in preparation for delivery. We are excited with this proposition and look forward to trying it.”
— Basimenye Nhlema, Director of Community Health for PIH in Malawi
Basimenye Nhlema (PIH Malawi) and Lassana Jabateh (PIH Liberia) celebrate their new working relationship by dancing at an active case-finding campaign. Photo by Dan Palazuelos / Partners In Health