Community health volunteers as mediators of accessible and responsive community health systems: lessons from the Health Development Army in Ethiopia

Skyline photo of Ethiopian city

Many low (and some middle) income countries face critical shortages of health workers. Governments have sought to compensate by using community volunteer health workers.

Using Ethiopia as a case study, we want to know whether - when faced with scarce resources - community health volunteers can make a meaningful contribution to better health, and if so, under what conditions, and how their contribution can be optimised. We also examine what the different types of community health workers actually do, their relationship with their local communities, the barriers to them doing more (both in terms of scope and quality of practice), and what they might do with appropriate support.

This study will generate timely, policy-relevant information, identifying bottlenecks to improving access to key services and promoting partnerships with communities. It will also develop plans for a subsequent evaluation of the Health Development Army, working in partnership with health authorities at all levels. Although focused on Ethiopia, the findings will be relevant to those planning community health worker initiatives in resource-poor settings elsewhere.

The project is led by the London School of Hygiene & Tropical Medicine (Principal Investigator: Dina Balabanova), in partnership with University of Jimma in Ethiopia (Mirikuzie Woldie), and University of Glasgow (Co-Investigator: Kirstin Mitchell).  Read more about the project.

It is funded by a MRC/DfID/Wellcome Global Health Systems Development Grant.

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