CHWs (54) CHWs and newborn care (2) 'Specialist CHWs'

8 November, 2019

'Specialist CHWs' and any such terminologies would deal a death nail to the whole CHW movement in many countries. We must remember that the concept is yet to be universally accepted in many countries, so beginning to call CHWs 'specialists' risks very serious backlash. Lets hold on to just CHW for the foreseeable future, even if they are trained in single curriculum arrangement. More important is defining their meaning and role; intensify the advocacy that they are accepted in the first place; undergo clearly structured training; and thereafter receive supportive supervision and monitoring of their performance; motivate them to go home with living wages; etc. [*see note below]

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 and the HIFA working group on Community Health Workers.

Email: jneana AT

[*Note from HIFA moderator (Neil PW): Joseph's comment is in response to my comment on HIFA earlier today:

"This is yet another area where CHWs can be trained to deliver specific tasks. In our discussion on CHWs, we tend to talk about them in generalities and forget that (a) the number of potential tasks that could be undertaken by CHWs is far more than could ever be expected of one cadre, and (b) CHWs are in fact a highly heterogenous group with diverse training needs. Many (an increasing percentage?) CHWs could be described as 'specialist CHWs', like the ones engaged in the above study. I am not sure we (or the CHW Guideline) have got to grips with this diversity and how to manage it. The Guideline notes that there can be no such thing as a universal curriculum, which had previously (and perhaps still is?) been promoted by many. Perhaps there is a case for a 'basic CHW training' followed by 'specialist CHW training'?"

It is clear that 'specialist CHWs' exist, and that they are necessary and will become increasingly so. Joseph's comment demonstrates the high continued sensitivity of CHWs as a concept, whereby terms such as 'specialist' are likely to be misunderstood and resisted.]