Health Workers’ Role in Health Service Integration
In the past decade, the global health field has seen a number of interventions that tried to integrate health services for various purposes. Integrating family planning and HIV services have helped countries make use of the resources available for the latter to expand the scope and coverage of services. TB and HIV service integration is another example of synergy to strengthen both programs. The advantage of integration for consumers is clear: patients get comprehensive services, whether in the community or at health facilities.
Focusing on health workers
Through the years, we have learned that it’s vital to strengthen the existing health system as a whole. In integrating health services, these initiatives bring a welcome focus on the key role of health workers who provide services across the system.
When the move to integrated programming came along, health workers were provided with integrated refresher trainings on how they could deliver multiple services during a single encounter with clients and patients. Lessons learned from integrated management of childhood illness (IMCI), for example, show that health workers are enabled to provide comprehensive services, appropriate referrals, and record-keeping when they work in integrated health service systems. In addition health workers are more empowered when provided with the capacity to provide comprehensive health services for their patients. Ethiopia’s experience with health extension workers (HEWs) reaffirmed the importance of integrated training of health workers by positioning these cadres to respond to the health needs of the communities.
The need for coordination
Apart from service provision, integrated programs require extensive coordination among the various supporting partners. Health workers’ productivity can be compromised when they get pulled into multiple training courses for separate programs and initiatives. Their workload also needs to be evaluated. It is also important to identify the expectations placed on the health workers compared with their actual ability to provide integrated services. Health workers’ turnover may challenge the success of health programs, irrespective of the extent of their integration. However, integrated health programs can withstand such challenges better than vertical programs, since each health worker is enabled to provide a wide range of services.
Working together
In the spirit of synergy, global health partners need to coordinate more effectively and share resources, experiences, and promising practices. To this end, CapacityPlus recently collaborated with the USAID Health Care Improvement Project (HCI) on the new CHW Central by providing related health workforce resources. CHW Central serves as a forum to link and engage experts and practitioners of community health programs, strengthening the support for community health workers in countries. It allows CapacityPlus to share latest developments and promising practices in HR management systems for community health programs and facilitate policy interventions to enhance CHW productivity. CapacityPlus continues to forge partnerships and collaborations globally and in countries to support integrated interventions that will enable health workers to continue to save lives.
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