Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
BRAC University, Dhaka, Bangladesh.
Health Res Policy Syst. 2021 Oct 12;19(Suppl 3):111. doi: 10.1186/s12961-021-00755-5.
This is the concluding paper of our 11-paper supplement, "Community health workers at the dawn of a new era".
We relied on our collective experience, an extensive body of literature about community health workers (CHWs), and the other papers in this supplement to identify the most pressing challenges facing CHW programmes and approaches for strengthening CHW programmes.
CHWs are increasingly being recognized as a critical resource for achieving national and global health goals. These goals include achieving the health-related Sustainable Development Goals of Universal Health Coverage, ending preventable child and maternal deaths, and making a major contribution to the control of HIV, tuberculosis, malaria, and noncommunicable diseases. CHWs can also play a critical role in responding to current and future pandemics. For these reasons, we argue that CHWs are now at the dawn of a new era. While CHW programmes have long been an underfunded afterthought, they are now front and centre as the emerging foundation of health systems. Despite this increased attention, CHW programmes continue to face the same pressing challenges: inadequate financing, lack of supplies and commodities, low compensation of CHWs, and inadequate supervision. We outline approaches for strengthening CHW programmes, arguing that their enormous potential will only be realized when investment and health system support matches rhetoric. Rigorous monitoring, evaluation, and implementation research are also needed to enable CHW programmes to continuously improve their quality and effectiveness.
A marked increase in sustainable funding for CHW programmes is needed, and this will require increased domestic political support for prioritizing CHW programmes as economies grow and additional health-related funding becomes available. The paradigm shift called for here will be an important step in accelerating progress in achieving current global health goals and in reaching the goal of Health for All.
这是我们 11 篇论文增刊“社区卫生工作者在新时代的黎明”的结论论文。
我们依靠集体经验、大量关于社区卫生工作者（CHW）的文献以及本增刊中的其他论文，确定了 CHW 计划面临的最紧迫挑战以及加强 CHW 计划的方法。
CHW 越来越被认为是实现国家和全球卫生目标的关键资源。这些目标包括实现与卫生相关的可持续发展目标，即全民健康覆盖、终结可预防的儿童和孕产妇死亡，以及对控制艾滋病毒、结核病、疟疾和非传染性疾病做出重大贡献。CHW 还可以在应对当前和未来的大流行病方面发挥关键作用。基于这些原因，我们认为 CHW 现在正处于新时代的黎明。虽然 CHW 计划长期以来一直是资金不足的事后想法，但现在它们已成为新兴卫生系统的基础。尽管受到了更多的关注，CHW 计划仍然面临着同样紧迫的挑战：资金不足、缺乏供应品和商品、CHW 的薪酬低、监督不足。我们概述了加强 CHW 计划的方法，认为只有当投资和卫生系统支持与言论相符时，CHW 计划的巨大潜力才会实现。还需要进行严格的监测、评估和实施研究，以使 CHW 计划能够不断提高其质量和效果。
需要为 CHW 计划提供可持续的资金大幅增加，这将需要随着经济增长和获得更多与健康相关的资金，增加国内对优先考虑 CHW 计划的政治支持。这里呼吁的范式转变将是加速实现当前全球卫生目标和实现人人享有健康目标的重要一步。
