CHWs (46) Reflections on CHW Discussion Week 1 (2)

10 June, 2019

Amelia, thanks for sharing your reflections.

In Nigeria CHW are called Community Health Practitioners (CHP) comprising from the top: community health officers (CHO), then community health extension workers (CHEW) and finally junior community health extension workers (JCHEW).

They all have selection and training criteria, their curricula, and certification after training in schools / colleges of Technology. They have job descriptions linked to their respective curriculum and when employed have their career paths. The JCHEWs progress to CHEWs and then to CHO. They are full time or part time depending on the employer but they are all salaried in employment and are pensionable. Today they are essential and invaluable for the running of the primary health care tier of health service across the country.

Now, this is why in my first posting in this current discussion I reiterated my earlier view that definition of what CHW means varies as there are countries and so previous discussions had led nowhere because some members were discussing apples and others were talking about bananas, so to say.

For us therefore one of the major benefits of the WHO guideline under discussion is that it provides a unifying definition so that in the end every stakeholder will approach the subject matter from the same perspective.

Joseph Ana

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group: jneana AT