What is the evidence base for interventions intended to empower communities and individuals for greater health self-reliance? What are the emerging lessons and recommendations for increasing self-reliance?
Current levels of human resources are not enough to meet the health Millennium Development Goals and Universal Health Coverage. There is growing recognition that human resources beyond a trained health workforce can be considered as ‘assets’ and be utilised to achieve these goals. Community Health Workers (CHWs) and other Front-Line Health Workers can provide a key role in delivering primary healthcare care services, especially in accessing hard-to-reach and underserved populations, in a convenient, high quality and cost-effective manner. Although they have been used for many years, the scale up and sustainability of successful CHW and other community intervention programmes is not yet a reality and for which further research is required.
This report provides an introduction to the literature on community and individual empowerment to improve health outcomes. Evidence of community intervention programmes is presented along with tools and approaches that are used to motivate and involve communities in health behaviour change interventions. Country examples of approaches and their impact on efforts to empower communities for health improvement are highlighted. Finally, a summary of reports, meetings and policies that review the evidence base, identify key themes/principles of successful interventions and provide recommendations for promoting and supporting increasing self-reliance is provided.