Performance Evaluation of Community Health Workers: Case Study in the Amazon of Peru.

Publisher: Springer Country of Publication: Netherlands NLM ID: 7600747 Publication Model: Print Cited Medium: Internet ISSN: 1573-3610 (Electronic) Linking ISSN: 00945145 NLM ISO Abbreviation: J Community Health Subsets: MEDLINE

Publication: Amsterdam : Springer
Original Publication: New York, Human Sciences Press.

Community Health Workers/*organization & administration ; Health Promotion/*organization & administration ; Health Services Accessibility/*organization & administration ; House Calls/*statistics & numerical data ; Maternal-Child Health Services/*organization & administration ; Referral and Consultation/*statistics & numerical data; Child ; Community Health Workers/education ; Female ; Humans ; Medically Underserved Area ; Peru ; Pregnancy ; Program Evaluation ; Rural Population/statistics & numerical data

A shortage in human resources for health is a growing crisis that has led to an inability to provide adequate health services to impoverished populations. By "task-shifting", health systems can delegate certain activities, such as health promotion and referral, to trained community members to help fill the human resource gap. An effective community health agent program can improve maternal and child health and overall effectiveness of rural health systems. Such a program is most effective when the community health agents receive supervision and evaluation of their performance. There is a shortage of literature that provides instruction and example on how to conduct a performance evaluation in the developing world to improve maternal and child health outcomes. The current study provides a case study of a performance evaluation in the Amazon region of Peru and how the findings can be used to make program adjustments. A set of instruments to measure the performance of CHWs was adapted from the literature and then implemented in the field. The instruments were used to measure the quality of home visits by the CHWs, their knowledge of the health topics, and structural activities. Three communities with an active CHW program in Loreto, Peru were chosen to receive the evaluation. All CHWs in the communities were evaluated. The scores from the evaluation were compared internally to identify strengths and weaknesses of the program and within the population of CHWs. The evaluation was completed on 52 home visits and 27 CHWs in three communities. The CHWs were found to be most effective at creating good relationships with caregivers and delivering health messages, and least effective at interacting with the child during the home visit and using material to deliver health messages. The evaluation instruments were well suited for the CHW program that utilizes home visits to teach about child health and development.

Bull Pan Am Health Organ. 1990;24(2):183-96. (PMID: 2379023)
Future Child. 2009 Fall;19(2):119-46. (PMID: 19719025)
J Glob Health. 2017 Jun;7(1):010906. (PMID: 28685044)
PLoS One. 2011;6(12):e27997. (PMID: 22194801)
Educ Health (Abingdon). 2006 Nov;19(3):385-7. (PMID: 17178522)
Lancet. 2004 Oct 30-Nov 5;364(9445):1595-602. (PMID: 15519629)
Cien Saude Colet. 2011;16 Suppl 1:1023-8. (PMID: 21503451)
BMC Public Health. 2013 Sep 13;13:847. (PMID: 24034792)
Infant Ment Health J. 2016 May;37(3):193-207. (PMID: 27079807)
PLoS One. 2017 Oct 12;12(10):e0186263. (PMID: 29023517)
Rev Lat Am Enfermagem. 2006 Nov-Dec;14(6):957-63. (PMID: 17294032)
Lancet. 2003 Jul 5;362(9377):65-71. (PMID: 12853204)
PLoS One. 2013 Sep 04;8(9):e72788. (PMID: 24023773)
PLoS Med. 2011 Mar;8(3):e1000428. (PMID: 21445330)
Am J Trop Med Hyg. 2006 Jul;75(1):126-32. (PMID: 16837718)
Lancet. 2007 Jun 23;369(9579):2121-31. (PMID: 17586307)
Rev Med Chil. 2011 Jan;139(1):60-5. (PMID: 21526318)
Cochrane Database Syst Rev. 2013 Oct 08;(10):CD010414. (PMID: 24101553)
Glob Health Action. 2014 May 08;7:24085. (PMID: 24815075)
Lancet. 2004 Sep 4-10;364(9437):900-6. (PMID: 15351199)
PLoS One. 2014 Apr 15;9(4):e94948. (PMID: 24736623)
Glob J Health Sci. 2012 Jul 26;4(5):78-90. (PMID: 22980380)
Lancet. 2005 Sep 17-23;366(9490):1026-35. (PMID: 16168785)
Am J Trop Med Hyg. 2012 Nov;87(5 Suppl):111-9. (PMID: 23136286)
PLoS One. 2017 Sep 14;12(9):e0183316. (PMID: 28910328)
Int J Health Plann Manage. 2001 Jul-Sep;16(3):195-205. (PMID: 11596557)
Annu Rev Public Health. 2014;35:399-421. (PMID: 24387091)
Public Health Nurs. 2002 Jan-Feb;19(1):11-20. (PMID: 11841678)
Int J Qual Health Care. 2002 Dec;14 Suppl 1:57-66. (PMID: 12572788)

Keywords: Child health; Community health; Health systems; Human resources for health; Implementation science

Date Created: 20180328 Date Completed: 20190924 Latest Revision: 20190925

20221213

10.1007/s10900-018-0503-3

29582342