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Table 2 Mapping priority areas of CHW program harmonization to analytic framework

From: Harmonizing community-based health worker programs for HIV: a narrative review and analytic framework

  Coordination Integration Sustainability
Health issue Coordination between HIV and other health priorities; availability of a standardized community healthcare package Variability in health priorities between national and sub-national levels Easily identifiable health issues; broadness of focus and training of CHWs; reach of coverage of services
Intervention Existence of cadres with specialized skills (which may be more complex to manage and evaluate); existence of parallel training and support structures for CHWs Equivalence between differently trained CHWs; CHW hiring procedures; level of workload and supervision of CHWs; existence of standardized incentives; level of professionalization Level of workload and supervision of CHWs; local modifiability; existence of standardized incentives; community participation and involvement of local decision-makers; CHW demographics; gender bias
Stakeholders Number of stakeholders; awareness of need for coordination; existence of similar funding timelines, forums (such as working groups) and reports; result-oriented programming and reporting; “NGO challenge” Perceived effectiveness of program; involvement of multiple public or private actors; position and power of health professionals; pace of CHW scale-up; dependence on external actors Strength of leadership; level of commitment to coordination and integration; dependence on external actors; perceived effectiveness of the intervention; level of community buy-in
Health system Existence of a single organizational structure dedicated to community health initiatives; level of decentralization; training of health workers; coordination with health facilities Formal recognition of CHW programs by government; parallel supply chains; standardized training, supervision and monitoring of CHWs; public or private capacity; existence of a common funding pool Public or private resources; existence of CHW training refreshers; attrition among young CHWs; coordination and integration of CHW programs; “NGO challenge”; predictability of funding
Broad context Level of political support among all stakeholders and across government levels (or large private providers) for CHW-led services Level of CHW program compatibility with local (community) structures; socioeconomic context and cultural values; political support for CHWs; community perception Level of alignment with community norms and needs; level of political support and economic growth; level of support from external actors
  1. CHW community health worker, NGO non-governmental organization, MOH Ministry of Health