1. COMMUNITY HEALTH WORKER
PROGRAMMING
Do NGOs need a principle of
practice?
Core Group Fall Meeting October 11th -12th

2. Emerging Issues in CHW programmes
• Inappropriate reporting structures
• Increased trust in NGOs as service providers
• Mosaic training systems
• Competitive working strategies
• Diverse incentives amongst NGOs and project types
• Parallel services and supply chain management
• Quality & reporting diversity
• Lack of consistent supervision systems
• Grant based programmes versus long-term investments

3. Need for a Principle of Practice
• Call for a “Three ones” style approach to CHWs in health
workforce crisis countries
• Eliminate the competitive working practices, without stifling
creative approaches to delivery
• Establish minimum working standards and principles for NGOs
engagement with CHWs within a country
• Framework on which to advocate for stronger country
investment and leadership in community health

4. “Principles of practice” uses:
• Interagency statement on CHW engagement in health workforce
crisis countries
• Recommendations for how iNGOs can partner with governments
to deliver quality CHW programmes
• Series of recommendations to support policy and advocacy work
• Recommendations for individual programmes that will support
the principles

5. Principle 1.
Advocate for the legitimization and recognition
of the CHW workforce within the formal health
system through appropriate country policies and
initiatives that support registration, accreditation
and minimum standards for the role and
performance of different cadres.

6. Principle 2.
Enable and support country leadership including
national or regional coordination bodies
empowered to provide oversight in CHW
programme implementation across partner
organizations and health authorities.

7. Principle 3.
Work with and through existing local health
services and mechanisms to strengthen them,
avoiding the creation of parallel CHW services,
methods and supply chains or competitive
working practices.

8. Principle 4.
Establish standards and methods for performance-
based incentives systems which are ethical, non-
competitive and sustainable, and under a unified
country policy.
Recommendations
• One Country One Policy – across NGOs and different project types
• Community Participation and Accountability
• Non-payment of services
• Only sustainable incentives schemes are implemented
• Reasonable compensation
• Performance based application of incentives
• Non-financial incentives and advancement

9. Principle 5.
Establish and agree on minimum standards for
training of specific cadres of CHWs under an
agreed unified system linked to performance-
based accreditation.

10. Principle 6.
Establish unified mechanisms for reporting
and management of community health worker
data that promote consistent quality monitoring,
supervision and accountability to existing health
structures and communities.

11. Principle 7.
Invest in appropriate low-tech innovations
judiciously through partnership approaches
which will enable improvements to CHW work
according to their capacity, and are available
within the public domain.

12. Next steps
• Establish interest amongst Core Group members
• Generate further discussion around the principles
• Establish a working group for a potential interagency
piece
• Contact Polly Walker polly.walker@worldvision.org.uk
• Shannon Downey sdowney@coregroupdc.org