The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow
Abstract Background Based in part on the success of India’s early community health worker (CHW) programs, the Government of India launched in 1977 a national CHW scheme—the Village Health Guides (VHGs)—to provide preventive, promotive, and basic curative care to rural populations. Although this prog...
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | Human Resources for Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12960-019-0413-1 |
| _version_ | 1818116599248322560 |
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| author | Rachel J. Strodel Henry B. Perry |
| author_facet | Rachel J. Strodel Henry B. Perry |
| author_sort | Rachel J. Strodel |
| collection | DOAJ |
| description | Abstract Background Based in part on the success of India’s early community health worker (CHW) programs, the Government of India launched in 1977 a national CHW scheme—the Village Health Guides (VHGs)—to provide preventive, promotive, and basic curative care to rural populations. Although this program had promising origins in smaller demonstration projects, it failed to deliver the hoped-for impact at scale and was abandoned. Based on extensive evidence and experience, the World Health Organization and the World Health Assembly have strongly endorsed the value of national CHW programs and their integration into national health systems. Surprisingly, given the scale and importance of the VHG program and its pioneering nature as a national CHW program, little has been published describing this experience. This article is the second in a series that focuses on critical issues that face the effectiveness of large-scale CHW programs. Case presentation Several systemic factors emerge as main contributors to the failure of the VHG Scheme, namely, a lack of support from the formal health sector, an overly hasty implementation of the scheme, and poor communication between the government and health centers about the role of the VHGs. The remuneration structure and the VHG selection process were at the root of the program’s shortcomings at the implementation level. Conclusion National CHW schemes are an increasingly important tool for achieving universal health coverage and ending maternal and child deaths by 2030. Although the VHG Scheme was initiated over 40 years ago, the lessons described in this case highlight important considerations to help both current and future large-scale CHW programs avoid the same pitfalls. |
| first_indexed | 2024-12-11T04:25:04Z |
| format | Article |
| id | doaj.art-e360355d1cda4cdfb245e188d8f891c5 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-12-11T04:25:04Z |
| publishDate | 2019-10-01 |
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| series | Human Resources for Health |
| spelling | doaj.art-e360355d1cda4cdfb245e188d8f891c52022-12-22T01:21:00ZengBMCHuman Resources for Health1478-44912019-10-011711810.1186/s12960-019-0413-1The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrowRachel J. Strodel0Henry B. Perry1Yale UniversityDepartment of International Health, Health Systems Program, Bloomberg School of Public Health, Johns Hopkins UniversityAbstract Background Based in part on the success of India’s early community health worker (CHW) programs, the Government of India launched in 1977 a national CHW scheme—the Village Health Guides (VHGs)—to provide preventive, promotive, and basic curative care to rural populations. Although this program had promising origins in smaller demonstration projects, it failed to deliver the hoped-for impact at scale and was abandoned. Based on extensive evidence and experience, the World Health Organization and the World Health Assembly have strongly endorsed the value of national CHW programs and their integration into national health systems. Surprisingly, given the scale and importance of the VHG program and its pioneering nature as a national CHW program, little has been published describing this experience. This article is the second in a series that focuses on critical issues that face the effectiveness of large-scale CHW programs. Case presentation Several systemic factors emerge as main contributors to the failure of the VHG Scheme, namely, a lack of support from the formal health sector, an overly hasty implementation of the scheme, and poor communication between the government and health centers about the role of the VHGs. The remuneration structure and the VHG selection process were at the root of the program’s shortcomings at the implementation level. Conclusion National CHW schemes are an increasingly important tool for achieving universal health coverage and ending maternal and child deaths by 2030. Although the VHG Scheme was initiated over 40 years ago, the lessons described in this case highlight important considerations to help both current and future large-scale CHW programs avoid the same pitfalls.http://link.springer.com/article/10.1186/s12960-019-0413-1Community health workersPrimary health careCommunity healthIndiaVillage Health Guides |
| spellingShingle | Rachel J. Strodel Henry B. Perry The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow Human Resources for Health Community health workers Primary health care Community health India Village Health Guides |
| title | The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow |
| title_full | The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow |
| title_fullStr | The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow |
| title_full_unstemmed | The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow |
| title_short | The National Village Health Guide Scheme in India: lessons four decades later for community health worker programs today and tomorrow |
| title_sort | national village health guide scheme in india lessons four decades later for community health worker programs today and tomorrow |
| topic | Community health workers Primary health care Community health India Village Health Guides |
| url | http://link.springer.com/article/10.1186/s12960-019-0413-1 |
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