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Community health workers in Ghana: the need for greater policy attention
  1. Leonard Baatiema1,2,
  2. Anthony Mwinkaara Sumah3,
  3. Prosper Naazumah Tang3,
  4. John Kuumuori Ganle4
  1. 1Integrated Social Development Centre, Tamale, Ghana
  2. 2Faculty of Health Sciences, School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
  3. 3Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana
  4. 4School of Public Health, University of Ghana, Accra, Ghana
  1. Correspondence to Leonard Baatiema; baatiemaleonard{at}gmail.com

Abstract

From the 1970s to the 1990s, the WHO, United Nations and other agencies mooted the idea of formally training and recognising community health workers (CHWs) to complement efforts to improve primary healthcare delivery in low and middle income countries. Recently, CHWs have been recognised as important players in the achievement of the health-related Millennium Development Goals (MDGs). Despite this recognition, little understanding exists in Ghana about the activities of CHWs: who they are; how they are recruited; what they do; level of health policy support; contribution to healthcare delivery and the challenges they face. Based on a rapid scoping review of the existing literature, and our experience working in Ghana, this paper reflects on the role of CHWs in healthcare delivery in Ghana. We argue that CHWs have played critical roles in improving health service delivery and outcomes, including guinea worm eradication, expanded immunisation coverage, maternal and child health, and HIV/AIDS treatment and management. However, these achievements notwithstanding, CHWs face challenges which prevent them from being optimally productive, including capacity problems, neglect by the healthcare system, high attrition rates and inadequate supervision. Policymakers in Ghana therefore need to give increased attention to CHWs, provide remuneration for their activities, create career opportunities and other means of motivations to boost their productivity and sustain gains associated with their activities.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Handling editor Douglas Noble.

  • Contributors LB and AMS conceived the study. LB, AMS, PNT and JKG searched the literature. LB drafted the manuscript. All authors contributed substantially to the review of the manuscript for critical and intellectual content. All authors have read and approved the final version of the manuscript for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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