WHO Global Health Workforce Alliance (GWHA) and

 A comprehensive response to the global human resources for health (HRH) crisis  Prompted by 3 consecutive WHA- generated resolutions (2004, 2005, 2006) to address various HRH issues  Helps accelerate the achievement of 2015 MDG Goals specifically MDGs 4 and 5 WHY the Global Health Workforce Alliance (GHWA)?

The Global Health Workforce Alliance (GHWA) st Global Forum GHWA launched Global CHW consultation 2 nd Global Forum

May 2006 GHWA launched a convener an open partnership not a funding entity board and a secretariat litmus test of GHWA efforts: evidence

Communities motivation career advancement training Central government Human security approach to CHW Local government Community Health Committee Top-down approach Protection Bottom-up approach Empowerment selection of CHWs, identification of priorities participation management, supervision & oversight mobilization training, supervision & oversight, authorization, financing, logistics OWNERSHIP

April 2010 Global CHW consultation in Montreus, Switzerland Objectives 1. Review the recommendations of the global systematic reviews and 8 country case studies. 2.Share experiences. 3.Develop a broad agreement on key messages for countries to integrate CHWs into their national health workforce.

I.Global systematic review II.Case studies of country CHW Programs and program review in 8 countries (Pakistan, Bangladesh, Thailand, Ethiopia, Uganda, Mozambique, Brazil, Haiti) applied HCI’s CHW assessment functionality tool visited countries to interview key personnel overseeing the program compiled information and reviews on programs (description, job descriptions, CHW roles) including evaluation reports and outcomes assessments

1. Integrate CHWs fully into national HRH plans and health systems. 2. Involve key stakeholders in the decision-making process. 3. Ensure effective and robust monitoring and evaluation throughout the policy and implementation process or the scale-up of CHWs. 4. Any scale-up of CHWs has adequate support including training, supervision, equipment and supplies, transport. 5. Existing health system should provide enabling environment for CHW policies and planned interventions. I. Planning, Production and Deployment (5) 13 Key Messages

6. Prepare and engage the community throughout the process. 7. Ensure a regular and sustainable stipend and, if possible, complement it with other rewards. 8.Ensure a positive practice environment. 9.Establish selection criteria, training duration, and scope of tasks that are clearly stated, publicized and respected by all stakeholders. 10. Provide an ongoing continuing education for CHWs and, where possible, support opportunities for career advancement. II. Attraction and Retention (5)

11. Governments should take responsibility for the quality assurance of CHWs, even if CHWs are trained and managed by civil society or private not-for-profit groups. 12. Performance management should be based on a minimum set of need-based skills. 13. The management and supervision of CHWs should be team-based and development-focused, and integrated with that of other health workers. III. Performance Management (3)

CHWs are integral to health systems strengthening and overall global health; Increasing services considered to be effective at the community level; Global health initiative emphasizes linking CHWs to overall health system; and Pressure is on governments and NGOs to provide support to CHWs in key areas, including incentives, supervision, standardized training, supplies. Source: Crigler L. Global Trends in CHW Programs. USAID-funded HCI Project 2010 Summary and Key Points