Community-based primary healthcare (CBPHC) involves using community health workers, who may or may not be paid, to deliver health services to under-served communities in remote areas. Community health workers are provided with training, tools and medicines to provide basic healthcare, and are taught what the danger signs are to refer a patient.
We believe this approach is a key mechanism to delivering vital health services to hard-to-reach areas. It is successfully implemented with guidance from a set of key principles and beliefs as set out below.
Engagement of community members
We look to involve as many members of each community as possible to help improve the health of their own communities. Our CBPHC programmes are therefore tailored to fit the context and meet specific needs of communities.
Community-led social and behaviour change communication strategies
We implement a number of different social and behaviour change communications activities within communities to encourage the use of services and to increase levels of health knowledge and community service delivery acceptance. This includes structured public discussions or dialogues, and community forums such as village health clubs where community members identify health challenges together.
Sustainability - in cooperation with governments to integrate CBPHC into the formal health service
We look to ensure that CBPHC acts as a complementary strategy that strengthens formal health services by reducing overcrowding, rather than damaging confidence in, or reducing uptake of, national health services. We consider CBPHC as a part of the continuum of care and therefore aim to strengthen linkages between communities and formal health facilities.
Evidence of impact at the community level
Quality research at the community level helps to measure effectiveness and ensure the sustainability, cost-effectiveness and quality of community-based health interventions. Our inSCALE project, for example, evaluated a range of interventions to improve the retention, motivation and performance of community health workers.
We support governments to strengthen integrated disease surveillance, which in turn contributes to the success of national malaria elimination strategies. Strong surveillance systems also play a key role in supporting global health security efforts.
Recognising where technology has a role to play
In Mozambique, for example, our upSCALE mHealth systems strengthening project is designing and implementing an integrated national mHealth system using real-time data collected by community health workers to improve the management and delivery of quality services.