Community health workers in humanitarian settings: Scoping review
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BACKGROUND: There is a need for greater understanding of experiences implementing community-based primary health care in humanitarian settings and of the adjustments needed to ensure continuation of essential services and utilization of services by the population, and to contribute to effective emergency response. We reviewed the evidence base on community health workers (CHWs) in humanitarian settings, with the goal of improving delivery of essential services to the most vulnerable populations. METHODS: We conducted a scoping review of published and grey literature related to health and nutrition services provided by CHWs in humanitarian settings. Extracted data from retained documents were analyzed inductively for key themes. RESULTS: Of 3709 documents screened, 219 were included in the review. Key findings from the literature include: 1) CHWs were often able to continue providing services during acute and protracted crises, including prolonged periods of conflict and insecurity and during population displacement. 2) CHWs carried out critical emergency response activities during acute crises. 3) Flexible funding facilitated transitions between development and humanitarian programming. 4) Communities that did not have a locally-resident CHW experienced reduced access to services when travel was limited. 5) Community selection of CHWs and engagement of respected local leaders were crucial for community trust and acceptance and high utilization of services. 6) Selection of local supervisors and use of mobile phones facilitated continued supervision. 7) Actions taken to maintain supplies included creating parallel supply chains, providing buffer stocks to CHWs, and storing commodities in decentralized locations. 8) When travel was restricted, reporting and data collection were continued using mobile phones and use of local data collectors. 9) CHWs and supervisors faced security threats and psychological trauma as a result of their work. CONCLUSIONS: To achieve impact, policy makers and program implementers will have to address the bottlenecks to CHW service delivery common in stable low-income settings as well as the additional challenges unique to humanitarian settings. Future interventions should take into account the lessons learned from years of experience with implementation of community-based primary health care in humanitarian settings. There is also a need for rigorous assessments of community-based primary health care interventions in humanitarian settings.
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CHWs can have important impacts in the midst of humanitarian disasters.
“We also know that CHWs can have important impacts in the midst of humanitarian disasters [76, 77].”
From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [77]
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Limiting the health impact of earthquakes: a call to action
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Community Health Workers’ Perspective on Family Functioning Among Sri Lankan Refugees
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62333 Health Workers in Conflict Zones: Responsibilities and Challenges
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Redesigning the Barefoot Doctor Model for Rural Syria: A Telemedicine-Enhanced Policy Framework
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- Authors
- Miller, N. P., Ardestani, F. B., Dini, H. S., Shafique, F., & Zunong, N.
- Affiliations
- United Nations Children's Fund (US)
- United Nations (US)
- ORCID
- Miller, Nathan P
- Venue
- Journal of Global Health
- Published
- 2020-12
- Volume
- 10
- Issue
- 2
- Pages
- 020602-020602
- ISSN
- 2047-2978 (ISSN-L)
- 2047-2986
- PMC
- PMC7719274
- OpenAlex
- W3112893153
- Cited by
- 72
- References
- 88
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 12 · 2023: 12 · 2022: 10 · 2021: 4
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Global Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- United States Agency for International Development
- UNICEF
- Office of U.S. Foreign Disaster Assistance
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Keywords
- community health workers, humanitarian settings, community-based primary care, emergency response, protracted crises, armed conflict, population displacement, essential health services, nutrition services, mobile phone data collection, supply chain resilience, safety stock, community trust, local leaders, psychological trauma, service utilization
- MeSH terms
- Community Health Workers, Community Health Services, Delivery of Health Care, Humans, Poverty, Primary Health Care, Relief Work, Vulnerable Populations
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