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Agregado, Zyrus Estelle-CPH_LAB_5.pdf - ACTIVITY NO. 5...

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ACTIVITY NO. 5COMMUNITY HEALTH WORKERSI. INTRODUCTIONThe umbrella term “community health worker” (CHW) embraces a variety ofcommunity health aides selected and trained. They are members of the communitieswhere they work, should be selected by the community, should be answerable to thecommunities for their activities, should be supported by the health system but notnecessarily a part of its organization, and have shorter training than professionalworkers.Community Health Workers carry out one or more functions related to healthcare delivery and are trained in some way for the interventions they are expected toperform. Not included, for example, are formally trained nurse aides, medical assistants,physician assistants, paramedical workers in emergency and fire services and otherswho are auxiliaries, mid-level workers and self-defined health professionals or healthparaprofessionals. They may receive training, which is recognized by the health servicesand national certification authority, but this training does not form part of a tertiaryeducation certificate.Lewin et al. defined CHW as “any health worker carrying out functions related tohealth care delivery; trained in some way in the context of the intervention; and havingno formal professional or paraprofessional certificated or degreed tertiary education”.CHW programs have a role to play that can be fulfilled neither by formal healthservices nor by communities alone. Ideally, the CHW combines service functions anddevelopmental/promotional functions that are, also ideally, not just in the field of health.The most important developmental or promotional role of the CHW is to act as a bridgebetween the community and the formal health services in all aspects of healthdevelopment. The bridging activities of CHWs may provide opportunities to increaseboth the effectiveness of curative and preventive services and, perhaps moreimportantly, community management and ownership of health-related programs.CHWs may be the only feasible and acceptable link between the health sectorand the community that can be developed to meet the goal of improved health in thenear term (Kahssay, Taylor & Berman, 1998). Although this concept of CHWs continuesto focus on their role in community development and bridging the gap betweencommunities and formal health services, their role as advocates for social change hasbeen replaced by a predominantly technical and community management function. Overthe years, and within the prevailing political climate, this pragmatic approach to CHWshas gained currency, and undoubtedly today constitutes the dominant approach,although the fundamental tension between their roles as extension worker and change

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