Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy

Council research is supporting the strengthening of frontline health worker programs in seven countries to improve health services for underserved populations. 

The Issue

Frontline health workers are often the first and only link to essential health services for millions of people worldwide, particularly those living in remote or rural areas. 

Recognized as critical agents of change at the community level, research suggests frontline health workers can have a positive impact on reproductive health and family planning services, HIV care and treatment, appropriate care seeking, antenatal care during pregnancy, and skilled care for childbirth. In fact, it is estimated that 77% of maternal, perinatal, neonatal, and child deaths could be averted if comprehensive and evidence-based community interventions reached all who need them.

Despite progress made to increase access to quality healthcare by bringing services directly to hard-to-reach populations, most countries lack official statistics on the performance of frontline health worker programs and do not have standardized training, skills, or defined functions. Coordinating performance metrics across diverse health worker programs is essential to ensuring effective frontline healthcare models, advocating for improved programs, and supporting their scale up.

The Progress

During this three-year project, the Council and its partners will examine effective ways of measuring the performance for frontline health workers to fully realize their potential and accelerate progress towards universal health coverage.

Using robust research in Liberia, Uganda, Democratic Republic of the Congo, Kenya, Mali, Haiti, and Bangladesh, the Council will identify and harmonize performance metrics, research effective primary healthcare models, and promote the use of evidence in frontline health worker programming.

The project will lead the global measurement, learning, and evaluation of frontline healthcare service delivery by:

  1. Developing a core set of metrics and facilitating data-sharing across community health partners and ministries of health;
  2. Building in-country capacity for the adoption and routine use of metrics;
  3. Identifying pathways to scale up for successful frontline health worker program models in diverse country contexts.

Research will explore the perspectives of frontline health workers and other stakeholders on how data can be used within countries to improve strategies for integrating locally relevant performance metrics into global frameworks. The potential support of mobile devices and technology and factors affecting scale up and sustainability will also be explored.  

The Impact

Strengthening and expanding the evidence base on high performance models for scaled frontline health worker initiatives is imperative at policy and program levels. The evidence generated from this project will shape shared performance metrics, promote effective frontline healthcare delivery models for replication, and clarify pathways to scale.

Through participatory processes and prompt dissemination in local, national, and global fora and publication, this new knowledge will inform policymakers, program managers, and donors seeking to understand the best mechanisms for institutionalizing frontline health workers within health systems and ultimately support improved access to healthcare among hard-to-reach communities.

Click here for project overview brief

Learn more about community health worker roles, support, and experiences in the context of the COVID-19 pandemic in Bangladesh, Haiti, and Kenya

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