There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care services, particularly in underserved, marginalized communities worldwide. As the global health community demonstrates an increasing commitment to investing in CHWs to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies.
Articles (peer-reviewed)
A conceptual framework for measuring community health workforce performance within primary health care systems, Smisha Agarwal, Pooja Sripad, Caroline Johnson, Karen Kirk, Benjamin Bellows, Joseph Ana, Vince Blaser, Meghan Bruce Kumar, Kathleen Buchholz, Alain Casseus, Nan Chen, Hannah Sarah Faich Dini, Rachel Hoy Deussom, David Jacobstein, Richard Kintu, Nazo Kureshy, Lory Meoli, Lilian Otiso, Neil Pakenham-Walsh, Jérôme Pfaffmann Zambruni, Mallika Raghavan, Ryan Schwarz, John Townsend, Brittney Varpilah, William Weiss, and Charlotte E. Warren
Community-based postnatal care services for women and newborns in Kenya: An opportunity to improve quality and access?, Brady Zieman, Timothy Abuya, Daniel Mwanga, John Wanyungu, Charlotte E. Warren, and Pooja Sripad
Confirming—and testing—bonds of trust: A mixed methods study exploring community health workers’ experiences during the COVID-19 pandemic in Bangladesh, Haiti and Kenya, Pooja Sripad, Ann Gottert, Timothy Abuya, Alain Casseus, Sharif M.I. Hossain, Smisha Agarwal, and Charlotte E. Warren
Development and validation of a multi-dimensional scale to assess community health worker motivation, Ann Gottert, Tracy McClair, Sharif M.I. Hossain, Sina Pascal Dakouo, Timothy Abuya, Karen Kirk, Benjamin Bellows, Smisha Agarwal, Sarah Kennedy, Charlotte E. Warren, and Pooja Sripad
"Eternally restarting" or "a branch line of continuity"? Exploring consequences of external shocks on community health systems in Haiti, Pooja Sripad, Alain Casseus, Sarah Kennedy, Benito Isaac, Kenia Vissieres, Charlotte E. Warren, and Ralph Ternier
Incentive preferences for community health volunteers in Kenya: Findings from a discrete choice experiment, Timothy Abuya, Daniel Mwanga, Melvin Obadha, Charity Ndwiga, George Odwe, Daniel Kavoo, John Wanyugu, Charlotte E. Warren, and Smisha Agarwal
Introduction of digital reporting platform to integrate community-level data into health information systems is feasible and acceptable among various community health stakeholders: A mixed-methods pilot study in Mopti, Mali, Karen Kirk, Tracy McClair, Sina Pascal Dakouo, Timothy Abuya, and Pooja Sripad
Measuring client trust in community health workers: A multi-country validation study, Pooja Sripad, Tracy McClair, Alain Casseus, Sharif M.I. Hossain, Timothy Abuya, and Ann Gottert
Measuring quality of care at the community level using the contraceptive method information index plus and client reported experience metrics in Bangladesh, Sharif M.I. Hossain, Pooja Sripad, Brady Zieman, Shongkour Roy, Sarah Kennedy, Md. Irfan Hossain, and Benjamin Bellows
Setting the global research agenda for community health systems: Literature and consultative review, Smisha Agarwal, Karen Kirk, Pooja Sripad, Benjamin Bellows, Timothy Abuya, and Charlotte E. Warren
The Client Empowerment in Community Health Systems Scale: Development and validation in three countries, Tracy McClair, Pooja Sripad, Alain Casseus, Sharif M.I. Hossain, Timothy Abuya, and Ann Gottert
Understanding community health worker incentive preferences in Uganda using a discrete choice experiment, Smisha Agarwal, Timothy Abuya, Richard Kintu, Daniel Mwanga, Melvin Obadha, Shivani Pandya, and Charlotte E. Warren
Audio/Video
Webinar—Applying Global Goods: Community Health Guidelines, Measurement and Planning Tools, Population Council and Frontline Health Project
Webinar: Community health measurement, learning, policy and practice, Frontline Health Project
Briefs
Assessing the performance of community health workers in Haiti: Key findings from a mixed-methods study, Frontline Health Project and Zanmi Lasante
Évaluation de la performance des agents de santé communautaires en Haïti: principales conclusions d’une étude à méthodologie mixte, Frontline Health Project and Zanmi Lasante
Exploring community health worker roles, support, and experiences in the context of the COVID-19 pandemic in Kenya, Frontline Health Project
Frontline Health achievements in harmonizing measurement and generating evidence on community health system performance, Frontline Health Project
Frontline Health: Harmonizing metrics, advancing evidence, accelerating policy—Project overview brief, Frontline Health Project
Health data reporting challenges in Mopti, Mali: Results and implications from a mixed-methods study, Frontline Health Project
Identifying factors that support community health worker motivation, job satisfaction, and retention in Haiti, Frontline Health Project and Johns Hopkins Bloomberg School of Public Health
Illustrative indicators for community health worker performance measurement, Frontline Health Project
Preferred incentives for improving community health worker satisfaction and retention in Bangladesh, Frontline Health Project and Johns Hopkins Bloomberg School of Public Health
Preferred incentives for improving Ugandan community health worker job satisfaction and retention, Frontline Health Project
The community health system in Bangladesh: An overview, Frontline Health Project
The community health system in Haiti: An overview, Frontline Health Project
The community health system in Mali: An overview, Frontline Health Project
The community health system in the DRC: An overview, Frontline Health Project
Understanding community health volunteer incentive preferences in Kenya, Frontline Health Project and Johns Hopkins Bloomberg School of Public Health
Using evidence to advocate for the professional growth of community health workers in Bangladesh, Frontline Health Project
Commentaries
Editorial: Advancing community health measurement, policy, and practice, Benjamin Bellows and Charlotte E. Warren
Strength in diversity: Integrating community in primary health care to advance universal health coverage, Charlotte E. Warren, Benjamin Bellows, Rachel Marcus, Jordan Downey, Sarah Kennedy, and Nazo Kureshy
Guides/Toolkits
Operationalized indicators: Integrating community health worker and client views to assess community health systems, Frontline Health Project
Scales to measure motivation among community health workers, and trust and empowerment among their clients: A guide, Frontline Health Project
Protocols
Understanding incentive preferences of community health workers using discrete choice experiments: A multicountry protocol for Kenya, Uganda, Bangladesh and Haiti, Smisha Agarwal, Udochisom Anaba, Timothy Abuya, Richard Kintu, Alain Casseus, Sharif M.I. Hossain, Melvin Obad, and Charlotte E. Warren