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APHA Scientific Session and Event Listing

Jirair Ratevosian, MPH '07, Department of International Health, Boston University School of Public Health, 715 Albany St, Talbot 4 West, Boston, MA 02118, 818-620-3171, jirair@bu.edu

In response to the lack of necessary support structures for health and the growing demands the HIV epidemic has placed on the people and communities in resource-poor settings, thousands of lay individuals have been trained by national governments or local NGOs to become community health workers (CHWs). Successful programs have shown CHWs facilitating the decentralization of life-saving services, increasing uptake of HIV treatment and prevention and other critical health services. However, efforts to develop community-level health programs have also failed because of poor design, inadequate political and financial commitment, unrealistic expectations and difficulties with maintaining quality. Kisumu Medical Education Trust's Home Based Care (HBC) program was established in rural Kenya to address the overburdening of hospitals with HIV/AIDS patients by providing basic psycho-social and palliative care. Despite some success in improving quality of life, a qualitative program evaluation has uncovered multiple areas of unmet need creating uncertainty about its own purpose. A worldwide review of programs has revealed that CHWs must be sufficiently supported by: on-going, context-relevant training, solid administrative supervision, strong logistical support and integration into existing health systems and effective monitoring and evaluation. Successful CHW efforts must also provide adequate compensation to attract and retain quality personnel. The future of effective and sustainable decentralized health care will depend on global health initiatives that significantly increase the overall supply, retention and support for CHWs.

Learning Objectives:

• Recognize and discuss the attributes associated with working effectively within a cultural setting in a foreign country.
• Articulate the strengths, weaknesses and challenges faced by an NGO working in a resource-poor setting.
• Develop strategies for how a resource-constrained service provider can apply public health principles to optimize work inputs and outputs.
• Apply the knowledge that I have gained from the classroom to help an NGO reassess its services and income allocations.

Keywords: Home Based, Community-Based Care

Related Web page: www.kmet.co.ke

Presenting author's disclosure statement:

Not Answered