Close-to-community health providers post 2015: Realising their role in responsive health systems and addressing gendered social determinants of health

Universal health coverage is gaining momentum and is likely to form a core part of the post MDG agenda and be linked to social determinants of health, including gender. Close-to-community health providers are arguably key players in meeting the goal of universal health coverage through extending and delivering health services to poor and marginalised groups. Because they are embedded in communities close-to-communty providers have the potential to understand intra household gender and power dynamics and how social determinants shape health and well-being. However, the opportunities to develop critical awareness and to translate this knowledge into health system and multi-sectoral action are poorly understood. Enabling close to community health providers to realise their potential requires health systems support and human resource management at multiple levels. The paper covers three themes. Firstly it discusses the role of close-to-community providers as extenders of services, secondly it considers their potential as social change agents and thirdly it briefly reviews the need to manage close-to-community providers to support them in carrying out their roles. The authors draw on existing evidence and make particular reference to Neglected Tropical Diseases (NTDs), maternal and newborn health and lung health (as core areas for the CAHRD consultation) and identify key areas for research and action.

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