Community health workers at the dawn of a new era: 2. Planning, coordination, and partnerships.
Community health workers at the dawn of a new era: 2. Planning, coordination, and partnerships.
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DOI：
10.1186/s12961-021-00753-7
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发表时间：
2021-10-12
影响因子：
4
通讯作者：
Perry HB
中科院分区：
文献类型：
--
作者：
Afzal MM;Pariyo GW;Lassi ZS;Perry HB
社区卫生工作者 (CHW) 在基层医疗保健中发挥着关键作用，对于实现与健康相关的可持续发展目标至关重要。尽管低收入和中等收入国家基本卫生工作者严重短缺，但世卫组织和国际合作伙伴已就需要扩大和加强社区卫生项目作为实现全民健康覆盖（UHC）的关键要素达成共识。 COVID-19 大流行进一步表明，新出现的健康挑战需要当地做出快速反应，例如利用社区卫生工作者的反应。这是我们 11 篇增刊《新时代黎明时的社区卫生工作者》中的第二篇论文。我们的目标是强调利益相关者在规划引入、扩展或加强大规模社区卫生工作者计划以及需要考虑的一系列复杂的协调和伙伴关系时需要考虑的问题、挑战和策略。作者借鉴了过去十年中与来自政策、实施、研究和开发组织的多位政府领导人和专家进行重要磋商时的讨论结果。其中包括 2010 年至 2014 年期间关于社区卫生工作者的全球磋商和卫生人力资源 (HRH) 会议全球论坛（蒙特勒、曼谷、累西腓、华盛顿特区）。它们还建立在作者直接参与全球卫生劳动力联盟的基础上。薄弱的卫生系统、糟糕的规划、缺乏协调和失败的伙伴关系导致各国社区卫生工作者项目黯淡无光。本文强调了普遍认为对国家社区卫生工作者计划的长期有效性至关重要的三个问题——规划、协调和伙伴关系。许多国家都有 UHC2030（以前的国际卫生伙伴关系）、国家协调机制 (CCM) 等机制，以及关注卫生人力的机制，例如国家卫生人力资源观察站和全球卫生人力联盟推出的国家协调和便利 (CCF) 举措。必须将社区卫生工作者的举措纳入正式卫生系统。需要采取多层面干预措施和多部门伙伴关系，全面应对国家和地方层面的挑战，从而确保合作伙伴和利益攸关方行动之间的协同作用。为了建立健全和制度化的流程，需要进行协调，提供可行的平台和有利的环境，让所有合作伙伴和利益相关者参与进来，以产生切实的成果。
Community health workers (CHWs) play a critical role in grassroots healthcare and are essential for achieving the health-related Sustainable Development Goals. While there is a critical shortage of essential health workers in low- and middle-income countries, WHO and international partners have reached a consensus on the need to expand and strengthen CHW programmes as a key element in achieving Universal Health Coverage (UHC). The COVID-19 pandemic has further revealed that emerging health challenges require quick local responses such as those utilizing CHWs. This is the second paper of our 11-paper supplement, “Community health workers at the dawn of a new era”. Our objective here is to highlight questions, challenges, and strategies for stakeholders to consider while planning the introduction, expansion, or strengthening of a large-scale CHW programme and the complex array of coordination and partnerships that need to be considered. The authors draw on the outcomes of discussions during key consultations with various government leaders and experts from across policy, implementation, research, and development organizations in which the authors have engaged in the past decade. These include global consultations on CHWs and global forums on human resources for health (HRH) conferences between 2010 and 2014 (Montreux, Bangkok, Recife, Washington DC). They also build on the authors’ direct involvement with the Global Health Workforce Alliance. Weak health systems, poor planning, lack of coordination, and failed partnerships have produced lacklustre CHW programmes in countries. This paper highlights the three issues that are generally agreed as being critical to the long-term effectiveness of national CHW programmes—planning, coordination, and partnerships. Mechanisms are available in many countries such as the UHC2030 (formerly International Health Partnership), country coordinating mechanisms (CCMs), and those focusing on the health workforce such as the national Human Resources for Health Observatory and the Country Coordination and Facilitation (CCF) initiatives introduced by the Global Health Workforce Alliance. It is imperative to integrate CHW initiatives into formal health systems. Multidimensional interventions and multisectoral partnerships are required to holistically address the challenges at national and local levels, thereby ensuring synergy among the actions of partners and stakeholders. In order to establish robust and institutionalized processes, coordination is required to provide a workable platform and conducive environment, engaging all partners and stakeholders to yield tangible results.
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影响因子：
8.1
作者：
Carter A;Akseer N;Ho K;Rothschild O;Bose N;Binagwaho A;Hirschhorn LR;Price M;Muther K;Panjabi R;Freeman MC;Bednarczyk RA;Bhutta ZA
通讯作者：
Bhutta ZA
影响因子：
10.8
作者：
Assefa, Yibeltal;Gelaw, Yalemzewod Assefa;Van Damme, Wim
通讯作者：
Van Damme, Wim
影响因子：
4.5
作者：
Dussault, Gilles;Franceschini, Maria Cristina
通讯作者：
Franceschini, Maria Cristina
影响因子：
11.1
作者：
Chotchoungchatchai S;Marshall AI;Witthayapipopsakul W;Panichkriangkrai W;Patcharanarumol W;Tangcharoensathien V
通讯作者：
Tangcharoensathien V
影响因子：
34.3
作者：
Cometto, Giorgio;Ford, Nathan;Taylor, David
通讯作者：
Taylor, David