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Pay-for-performance in resource-constrained settings: Lessons learned from Thailand’s Quality and Outcomes Framework

In 2010, Thailand introduced the first pay-for-performance (P4P) programme, called on-top payment, in order to reduce variations in quality and accessibility of care provision by encouraging CUPs to improve infrastructure and staffing. Since this programme was criticized for not clearly contributing to the quality of services and health outcomes, it was replaced by the Quality […]
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Effectiveness of Community Health Workers

Evidence supports Community Health Workers (CHWs) effectiveness in delivering a range of preventive, promotional and curative health services; reducing inequities in access to care; and supporting the empowerment of communities to demand social accountability from their governments and others to provide coverage of quality primary healthcare services. CHWs have the potential to contribute to the […]
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Community Health Worker Assessment and Improvement Matrix - Updated Program Functionality Matrix for Optimizing Community Health Programs

To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale […]
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Community Health Worker Incentives and Disincentives: How They Affect Motivation, Retention, and Sustainability

This paper examines the experience with using various incentives to motivate and retain community health workers (CHWs) serving primarily as volunteers in child health and nutrition programs in developing countries. It makes recommendations for more systematic use of multiple incentives based on an understanding of the functions of different kinds of incentives and emphasizes the […]
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What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers

We identified 122 reviews (75 systematic reviews, of which 34 are meta-analyses, and 47 non-systematic reviews). Eighty-three of the included reviews were from low- and middle-income countries, 29 were from high-income countries, and 10 were global. CHW programs included in these reviews are diverse in interventions provided, selection and training of CHWs, supervision, remuneration, and […]
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