Hi Daniel, [in response to Daniel Stern: Tanzania/Uganda: http://www.hifa.org/dgroups-rss/chws-114-certification-chws-7 ]
I couldn’t agree with you more. I have seen CHWs with little education in India, Tanzania and Zambia learn skills and provide excellent quality services. I think the question is not can CHWs, with variable levels of education, be trained and perform, but how do we maintain the dynamism and diversity of CHWs as programs formalize? For example, in creating national salaried cadres of CHWs, countries such as Tanzania, Zambia and others have found that to be paid through the civil service, CHWs have to meet civil service education requirements (frequently grade 10, 12 and a certain number of O levels) and this leaves out many of the existing CHWs trained to provide MNCH, HIV or other services. The same is true in the US, as states move to create formal certification programs, they grapple with how to ensure that valuable and existing trained workers are not “left behind” because they do not meet newly established criteria for certification. Many states have dealt with this by putting in place systems to “grandfather” in existing workers, enabling them to become certified by taking into account experience over certain minimum education requirements, for example, while simultaneously establishing new education and training requirements for new CHWs.
HIFA profile: Rebecca Furth is a public health specialist and cultural anthropologist. She is a Senior Technical Advisor at Initiatives Inc., USA and Technical Manager for www.CHWCentral.org. Her professional interests include human resources for health, community health worker program strengthening, organizational development, health systems strengthening, and culture and development. She is a member of the HIFA working group on CHWs. http://www.hifa.org/support/members/rebecca-0 rfurth AT initiativesinc.com