A community health systems approach 2020
Over one billion people cannot use the health services they need because they are either unavailable or unaffordable. Health workforce deficiencies, inadequate distribution and quality and performance challenges represent some of the main obstacles to the scaling up of essential health interventions.
Addressing these challenges is essential for progress towards Sustainable Development Goal 3 to “ensure healthy lives and promote well-being for all at all ages” and to guarantee Universal Health Coverage (UHC).
Projections estimate a potential shortfall of 18 million health workers in low- and lower-middle-income countries if UHC is to be achieved by 2030. Health systems strengthening to address this shortage of human resources for health, with an emphasis on community-based primary healthcare and workforce, is the need of the hour.
Task shifting through the engagement of community-based health workers (CBHWs), including trained community health volunteers and other health workers, is increasingly being recognized for its potential contribution to meeting the urgent health workforce challenges. The IFRC and its member National Societies have a unique advantage among relief, development and international humanitarian organizations in advocating, planning and implementing a task sharing and role delegation approach to Care in the Communities programming. First, they have access to communities that are the most isolated and exposed to disaster risks. Second, the auxiliary role to public authorities, including health authorities, allows them to play an active role in linking those communities to the health system. Third,
National Societies can reach the most marginalized and excluded populations through their networks of volunteers.
Red Cross Red Crescent volunteers have a personal understanding of people’s needs, circumstances and of the overall social context. As community-based humanitarian organizations which are auxiliaries to the public authorities, National Societies are well positioned to strengthen the links between vulnerable communities, their volunteers and the formal health system. Besides health promotion and education, CBHWs, including trained community health volunteers, can bridge the gap in communitybased human resources for health by working together with communities to help them to take charge of their own health, and by providing essential, evidenced-based community health service packages in a timely, equitable, affordable and acceptable manner. Tackling community health requires holistic, complex and comprehensive solutions through a life course approach, focusing on prevention (at primary, secondary and tertiary levels), access to early diagnostic, screening, treatment and care and advocating for policy changes with an enabling environment and innovative solutions to improve access to care.
These guidelines were developed through consultation with and contribution from National Societies, subject matter experts and a range of key stakeholders. The result is comprehensive guidance on the implementation of community-based care and support programmes that are adaptable and suitable for implementation in diverse settings. These guidelines should be used to assist programme managers in National Red Cross Red Crescent Societies in the design, implementation and evaluation of CIC programmes.