Community-based Health Information Systems in the Global Context: A Review of the Literature
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Author(s): MEASURE Evaluation
In developing countries, high disease burden from HIV, malaria, tuberculosis, poor nutrition, and high maternal mortality often intersects with low access to health services (Global Fund, 2014). Community workers (CWs), including community health workers (CHWs), community health extension workers (CHEWs) and community social service providers, have met critical service gaps. Generally, CWs are affiliated with either health facilities or community-based organizations. These providers live in the communities they serve and provide outreach services to people who may otherwise not receive them. The work of community worker providers has helped to improve health, especially maternal, child, and newborn outcomes (Lunsford, 2015; Golding, 2014).
National governments and donors are increasingly emphasizing and supporting the work of CWs to expand health care coverage (de la Torre, 2014). The important role of CWs has been emphasized in recent global health policy, such as USAID’s policy for ending preventable child and maternal deaths (EPCMD) (USAID, 2015) and the President’s Malaria Initiative. Similarly, there is a recognition that decentralized, community-based approaches to HIV care and support will be required to meet UNAIDS’ 90-90-90 target (90% of all people living with HIV will know their status, 90% of people diagnosed with HIV to receive antiretroviral treatment (ART), and 90% of all people receiving ART will be virally suppressed by 2020) (UNAIDS, 2014). Community-based programs implemented by CWs are uniquely suited to help achieve the goals laid out in these policies in the most vulnerable parts of the world. Furthermore, as global health systems move toward universal health coverage, CWs will become even more important to increase health equity (Golding, 2014).
CWs require key health information to do their jobs, and their managers require information to monitor their work. Likewise, Governments and donors require information to better plan community health programs, and to monitor progress against goals. This information, how it is collected, and how it flows, is how we define a community-based health information system(s) (CBHIS). These systems should involve data collection, management, and analysis of health and related services provided to communities outside of facilities (de la Torre, 2014). They should enable information to be shared among community-based services and between community-based services and higher-level health facilities. Moreover, to some extent, they should feed into national health management information system(s) (HMIS). CBHIS have the potential to engage community members, provide them with an avenue to health services, and hold them accountable, contributing to the goals of sustainability (Jeremie, 2014; Sabitu, 2004).
Little is known about how CBHIS are being implemented globally. This literature review seeks to explore the innovations in and different manifestations of CBHIS in developing countries.
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