As part of the development of the WHO CHW Guideline, 'a stakeholder perception survey was conducted to assess the acceptability and feasibility of the policy options under consideration in the guideline by stakeholders, with a view to increasing uptake and use of the emerging recommendations'.
Below is a summary of this from the Guideline:
A total of 96 submissions were obtained, with representation largely from policy-makers, planners, managers and researchers involved in the design, implementation, monitoring and evaluation of CHW programmes. The majority of the respondents were from the African Region; a limitation was that CHWs themselves were not adequately represented in this group. All outcomes of the CHW interventions were deemed to be at least important and several were rated as critical. The most critical outcomes were increased health service coverage and improved quality of health services provided by CHWs. Most of the health policy and system interventions under consideration in the guideline were also deemed to be acceptable and feasible for implementation. Acceptability and feasibility were uncertain for a few interventions considered, such as the use of essential and desirable attributes to select CHWs for pre-service training; these included, for example, selecting CHWs on the basis of age and completion of a minimum secondary level of education. The findings of the survey – presented in Annex 5 – informed the development of evidence to decision tables and ultimately the recommendations by the GDG.
Annex 5 notes: 'The survey was disseminated in English and French languages to stakeholders through three major channels: WHO human resources for health contact list, the Health Information For All (HIFA) online platform, and participants at the 2017 Institutionalizing Community Health Conference held in South Africa in 2017.'
Our thanks to HIFA members who completed the survey. The potential population surveyed is in the 10s of 000s (HIFA-English alone has 11,500). Perhaps unsurprisingly (survey fatigue) this suggests a response rate of a fraction of 1 per cent.
On HIFA, we have found that dynamic interaction among a global, multidisciplinary community (thematic discussions, such as the one we are having now) can provide rich content and insights that cannot be obtained from static online surveys. Such interactions could play an important complementary role in addition to online surveys, as part of the guideline development process. Perhaps there is a role for inclusion of thematic discussions on forums such as HIFA as part of the guideline development process (in selected cases)? I would be interested to hear from members of the CHW Guideline Development Group their thoughts on this.
Best wishes, Neil
Coordinator, HIFA Project on Community Health Workers
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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG firstname.lastname@example.org