Compensation models for community health workers

Comparison of legal frameworks across five countries

Bibliographic Data

ID19551503
AuthorsMadeleine Ballard (0000-0003-0107-4047, Icahn School of Medicine at Mount Sinai, corresponding author), Carey Westgate (0000-0003-4435-1286, Community Impact), Rebecca Alban (0000-0002-2337-4406, VillageReach), Nandini Choudhury (0000-0003-4127-1176, Mount Sinai Health System), Rehan Adamjee (0000-0003-4632-7132, VITAL Pakistan, Karachi, Pakistan), Ryan Schwarz (0000-0001-8486-8373, Possible Health), Julia Bishop (0000-0003-1926-9715), Meg McLaughlin (THINKMD, Burlington, Vermont, USA), David Flood (0000-0003-1698-2865, Probigua), Karen E Finnegan (0000-0001-9007-5417, PIVOT), Karen Finnegan (PIVOT, Ranomafana, Madagascar), Ash Rogers (0000-0002-7480-930X, Community Partners), Helen Elizabeth Olsen (0000-0003-1255-5508, T-Mobile (United States)), Helen Olsen (Medic Mobile, San Francisco, California, USA), Ari Johnson (0000-0002-7048-5467, Mali-Folkecenter), Daniel Palazuelos (0000-0003-3701-0707, Harvard University), Jennifer Schechter (Togolese Ministry of Health)
Year2021
Volume11
Pages04010-04010
Publication date2021-02-15
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.11.04010
PMID33692894
OpenAlexW3132673544
LanguageEN
Citations received19
References cited15

BACKGROUND: , there is an urgent need to better understand the types of CHW payment models and their implications. METHODS: This study examines the legal framework on CHW compensation in five countries: Brazil, Ghana, Nigeria, Rwanda, and South Africa. In order to map the characteristics of each approach, a review of the regulatory framework governing CHW compensation in each country was undertaken. Law firms in each of the five countries were engaged to support the identification and interpretation of relevant legal documents. To guide the search and aid in the creation of uniform country profiles, a standardized set of questions was developed, covering: (i) legal requirements for CHW compensation, (ii) CHW compensation mechanisms, and (iii) CHW legal protections and benefits. RESULTS: The five countries profiled represent possible archetypes for CHW compensation: Brazil (public), Ghana (volunteer-based), Nigeria (private), Rwanda (cooperatives with performance based incentives) and South Africa (hybrid public/private). Advantages and disadvantages of each model with respect to (i) CHWs, in terms of financial protection, and (ii) the health system, in terms of ease of implementation, are outlined. CONCLUSIONS: While a strong legal framework does not necessarily translate into high-quality implementation of compensation practices, it is the first necessary step. Certain approaches to CHW compensation - particularly public-sector or models with public sector wage floors - best institutionalize recommended CHW protections. Political will and long-term financing often remain challenges; removing ecosystem barriers - such as multilateral and bilateral restrictions on the payment of salaries - can help governments institutionalize CHW payment

Business · Developing country · Economic growth · Economics · Incentive · Payment · Political science · Public health · Public relations · Remuneration · Global Health Workforce Issues · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Nursing · Psychology · Finance