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Service delivery model
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| Use of CHWs (task-shifting) |
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Community involved in selection of CHWs, deployment and retention Commitment from community and families to support CHWs Baseline and annual refresher training for CHWs Established links between clinic-based services and mobile teams Opportunities for women in rural areas—education, work in health delivery
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PHC system financing
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| Contracting to non-state providers |
Afghanistan (PHC)77
Bangladesh (PHC)65
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Bonus system linked to health equity targets Health worker education, supervisory visits and supportive supervision; quality of care NGO greater flexibility in reallocating fixed budget CHWs actively referring patient to NGO-funded tertiary facilities Available/improved infrastructure and medicines Wider variety of service offered Closer ties to community Organised outreach services
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Community engagement
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| Community empowerment/ownership |
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Community-led monitoring, planning and action Engagement of community leaders: village health committees, women’s leadership Data shared with community, consultation on service improvement Community mortality data registries available to provide evidence of health inequities
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Patient
management tools
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| Digital health: mobile phone/tablet-based decision support tool |
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CHWs able to undertake guideline-based screening in remote areas Efficient referral links to facility-based services Improved access to care through telehealth consultations Reduction of stigma in the community
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