[Note from HIFA moderator (NPW): Our discussion on CHWs is taking place on all six HIFA forums, in English, French, Portuguese and Spanish (see below on how to join them). The message below was posted today on our child health forum CHIFA]
Dear Neil, I wrote to you personally about my dis-agreement in respect of any program concerning CHWs. You suggested to me to write in CHIFA/HIFA.
I wrote about it in the past, now I do telegraphicaly.
1) CHWs are not supported by their communities. So far nobody wrote a convincing paper/letter/study where it is stated beyond any doubt that their community supported($) the work of CHWs and for long.
2) CHWs are neither supported($) by Governments. So far governments pay for their health workers that are officialy trained, wear a uniform, work in the thousand rural dispensaries/health centres/hospitals. This personnel is the one that communities recognized as their health providers, from ever. CHWs just came 'recently' brought forward by foreign INGOs that like the idea of their service and support($) them.
3) the idea of having CHWs originates from the love of PHC (primary health care), that was an excellent move in 1975, resisted for years but today has died, replaced by privatisation of services and market.
Let's concentrate efforts and support($) to the current health workers, those with a uniform, with drugs to prescribe. Let's help them to deliver a service of PHC and not simply prescription of drugs.
They are supposed to visit their communities, to talk with them, to assist children and mothers, to promote hygiene and good sanitation. Some do it despite the hardship and isolation they face.
After all they 'belong' to the community not less than CHWs, moreover they are regularly paid by their governments through tax collection. They are sustainable and long lasting...not certainly the CHWs.
Greetings from Dodoma
CHIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He currently works on a volunteer basis in an excellent missionary/credited hospital in north Uganda, St. Mary's Hospital-Lacor-GULU. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health. massimoser20 AT gmail.com
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