Describe Roles of Community Health Workers
Social Work & Role of Health Promotion Specialist Essay
Roles of Community Health Workers
The roles and activities of community health workers (CHWs) are tailored to meet the unique needs of the communities they serve. A CHWs’ role also depends on factors such as whether they work in the healthcare or social services sectors. Generally, CHWs hold the following roles:Social Work & Role of Health Promotion Specialist Essay
Creating connections between vulnerable populations and healthcare systems
Facilitating healthcare and social service system navigation
Managing care and care transitions for vulnerable populations
Reducing social isolation among patient populations
Determining eligibility and enrolling individuals into health insurance plans
Ensuring cultural competence among healthcare professionals serving vulnerable populations
Educating health system providers and stakeholders about community health needs
Providing culturally appropriate health education on topics related to chronic disease prevention, physical activity and nutrition
Advocating for underserved individuals to receive appropriate services
Collecting data and relaying information to policymakers to inform policy change and development Social Work & Role of Health Promotion Specialist Essay
Providing informal counseling, health screenings, and referrals
Building capacity to address health issues
CHWs promote access to services, provide health education, support care delivery, and promote advocacy. The specific role of CHWs in rural health programs is dependent on:Social Work & Role of Health Promotion Specialist Essay
Services provided through the program, such as:
Advocacy
Outreach and enrollment
Navigation
Education
Health services
Social-emotional support
Required CHW skills, such as:
Communication
Interpersonal
Cultural competence
Assessment
Training
Professional
Advocacy
Education
Facilitation
Health promotion is a behavioral social science that draws from the biological, environmental, psychological, physical and medical sciences to promote health and prevent disease, disability and premature death through education-driven voluntary behavior change activities.
Health promotion is the development of individual, group, institutional, community and systemic strategies to improve health knowledge, attitudes, skills and behavior.Social Work & Role of Health Promotion Specialist Essay
The purpose of health promotion is to positively influence the health behavior of individuals and communities as well as the living and working conditions that influence their health.
Why is health promotion important?
- Health promotion improves the health status of individuals, families, communities, states, and the nation.
- Health promotion enhances the quality of life for all people.
- Health promotion reduces premature deaths.
- By focusing on prevention, health promotion reduces the costs (both financial and human) that individuals, employers, families, insurance companies, medical facilities, communities, the state and the nation would spend on medical treatment.
Where are health educators employed?
In schools health educators teach health as a subject and promote and implement Coordinated School Health Programs, including health services, student, staff and parent health education, and promote healthy school environments and school-community partnerships. At the school district level they develop education methods and materials; coordinate, promote, and evaluate programs; and write funding proposals.Social Work & Role of Health Promotion Specialist Essay
Working on a college/university campus, health educators are part of a team working to create an environment in which students feel empowered to make healthy choices and create a caring community. They identify needs; advocate and do community organizing; teach whole courses or individual classes; develop mass media campaigns; and train peer educators, counselors, and/or advocates. They address issues related to disease prevention; consumer, environmental, emotional, sexual health; first aid, safety and disaster preparedness; substance abuse prevention; human growth and development; and nutrition and eating issues. They may manage grants and conduct research.
In companies, health educators perform or coordinate employee counseling as well as education services, employee health risk appraisals, and health screenings. They design, promote, lead and/or evaluate programs about weight control, hypertension, nutrition, substance abuse prevention, physical fitness, stress management and smoking cessation; develop educational materials; and write grants for money to support these projects. They help companies meet occupational health and safety regulations, work with the media, and identify community health resources for employees.Social Work & Role of Health Promotion Specialist Essay
In health care settings health educators educate patients about medical procedures, operations, services and therapeutic regimens, create activities and incentives to encourage use of services by high risk patients; conduct staff training and consult with other health care providers about behavioral, cultural or social barriers to health; promote self-care; develop activities to improve patient participation on clinical processes; educate individuals to protect, promote or maintain their health and reduce risky behaviors; make appropriate community-based referrals, and write grants.
In community organizations and government agencies health educators help a community identify its needs, draw upon its problem-solving abilities and mobilize its resources to develop, promote, implement and evaluate strategies to improve its own health status. Health educators do community organizing and outreach, grantwriting, coalition building, advocacy and develop, produce, and evaluate mass media health campaigns.Social Work & Role of Health Promotion Specialist Essay
Where can one receive health promotion or health education training?
Some people specialize in health education and seek training and certification as health education specialists. Others perform selected health education functions as part of what they consider their primary responsibility (medical treatment, nursing, social work, physical therapy, oral hygiene, etc.). Lay workers learn on the job to do specific, limited educational tasks to encourage healthy behavior.
Para-professionals and health professionals from other disciplines are not familiar with the specialized body of health education knowledge, skills, theories, and research, nor is it their primary interest or professional development focus. This will limit their effectiveness with clients and communities, and their cost-effectiveness.Social Work & Role of Health Promotion Specialist Essay
Health promotion requires intensive specialized study. Over 250 colleges and universities in the US, including the University of Georgia College of Public Health, offer undergraduate and graduate (Masters and Doctorate) degrees in school or community health education, health promotion and other related titles. Nationally, voluntary credentialing as a Certified Health Education Specialist (CHES) is available from the National Commission for Health Education Credentialing, Inc (NCHEC).
CHES competencies (health education needs assessment; program planning, implementation and evaluation; service coordination; and Health Education needs, concerns, resource communication) are generic to the practice of health education, whether it takes place in schools, colleges, workplaces, medical care settings, public health settings or other educational settings of the community. CHES are re-certified every five years based on documentation of participation in 75 hours of approved continuing education activities.
The use of community health workers has been identified as one strategy to address the growing shortage
of health workers, particularly in low-income countries. Using community members to render certain basic
health services to the communities they come from is a concept that has been around for at least 50 years.Social Work & Role of Health Promotion Specialist Essay
There have been innumerable experiences throughout the world with programmes ranging from largescale, national programmes to small-scale, community-based initiatives.
This review paper revisits questions regarding the feasibility and effectiveness of community health
worker programmes. It was commissioned by the World Health Organization as a follow-up to the World
health report 2006: working together for health, which identified as a research priority the feasibility of
successfully engaging community health workers. This review aims to assess the presently existing
evidence. It constitutes a desktop review, very broad in scope, as is evident from the title, which draws
together and assesses the evidence as it can be found in the published and selected “grey” literature since
the late 1970s.
The umbrella term “community health worker” (CHW) embraces a variety of community health aides
selected, trained and working in the communities from which they come. Generalizations about the profile
of community health workers internationally are difficult. While there are some broad trends, CHWs can
be men or women, young or old, literate or illiterate. More important is an acknowledgement that the
definition of CHWs must respond to local societal and cultural norms and customs to ensure community
acceptance and ownership.
The roles and activities of community health workers are enormously diverse throughout their history,
within and across countries and across programmes. While in some cases CHWs perform a wide range of
different tasks that can be preventive, curative and/or developmental, in other cases CHWs are appointed
for very specific interventions.
While it is difficult, given the extensiveness of the topic and the diversity of the literature informing the
review, to make generalizations about experiences with CHW programmes or answer the question of what
makes a good CHW programme, there is consensus in the literature on a number of issues:Social Work & Role of Health Promotion Specialist Essay
First, CHWs can make a valuable contribution to community development and, more specifically, can
improve access to and coverage of communities with basic health services. There is robust evidence that
CHWs can undertake actions that lead to improved health outcomes, especially, but not exclusively, in the
field of child health. However, although they can implement effective interventions, they do not
consistently provide services likely to have substantial health impact, and the quality of services they
provide is sometimes poor.
Second, for CHWs to be able to make an effective contribution, they must be carefully selected,
appropriately trained and – very important – adequately and continuously supported. Large-scale CHW
systems require substantial increases in support for training, management, supervision and logistics.
Third, CHW programmes are therefore neither the panacea for weak health systems nor a cheap option to
provide access to health care for underserved populations. Numerous programmes have failed in the past
because of unrealistic expectations, poor planning and an underestimation of the effort and input required
to make them work. This has unnecessarily undermined and damaged the credibility of the CHW concept.
Fourth, by their very nature CHW programmes are vulnerable unless they are driven, owned by and firmly
embedded in communities themselves. Where this is not the case, they exist on the geographical and
organizational periphery of the formal health system, exposed to the moods of policy swings without the
wherewithal to lobby and advocate their cause, and thus are often fragile and unsustainable. However, the
concept of community ownership and participation is often ill-conceived and poorly understood as a byproduct of programmes initiated from the centre. Evidence suggests that CHW programmes thrive in
mobilized communities but struggle where they are given the responsibility of galvanizing and mobilizing
communities.
Community health workers: what do we know about them? • Page vi
Examples of successful programmes can thus be found in the wake of community mobilization efforts,Social Work & Role of Health Promotion Specialist Essay
either as part of large-scale political transformation, such as in Brazil or China; or through local
mobilization, often facilitated by nongovernmental, community-based or faith-based organizations. In
many cases programmes last through the lifespan of the mobilization effort and wither or collapse entirely
as the momentum of mobilization is lost. The rhythms and dynamics of community participation lie
outside the scope of this review, yet are crucial to better understanding and discussing the future of CHW
programmes.
A key challenge lies in institutionalizing and mainstreaming community participation. To date, the largest
and most successful programme in this regard is the Brazilian Family Health Programme, which has
integrated CHWs into its health services and institutionalized community health committees as part of
municipal health services to sustain social participation. This means that community participation does not
become an alternative, but an integral part of the state’s responsibility for health care delivery.
Fifth, the question of whether CHWs should be volunteers or remunerated in some form remains
controversial. There exists virtually no evidence that volunteerism can be sustained for long periods: as a
rule, community health workers are poor and expect and require an income. Although in many
programmes they are expected to spend only a small amount of time on their health-related duties, leaving
time for other breadwinning activities, community demand often requires full-time performance. The
reality is that CHWs as a rule and by their very nature provide services in environments where formal
health services are inaccessible and people are poor. This also complicates the issue of community
financing, which is rarely successful unless institutionalized, as in China. Most of the evidence reflects
failures of community financing schemes, leading to high drop-out rates and the ultimate collapse of
programmes.
Given present pressures on health systems and their proven inability to respond adequately, the existing
evidence overwhelmingly suggests that particularly in poor countries, CHW programmes are not a cheap
or easy, but remain a good investment, since the alternative in reality is no care at all for the poor living in
geographically peripheral areas. While there is a lot to learn, there is a lot we do know about making
programmes work better: appropriate selection, continuing education, involvement and reorientation of
health service staff and curricula, improvement supervision and support are non-negotiable requirements.
These need political leadership and substantial and consistent provision of resources. We need to learn
from examples of large-scale successful programmes in this regard, particularly providing longitudinal
evidence of what works and what does not work. This presently constitutes the biggest knowledge gap.
CHW programmes have been revered as a panacea and decried as a delusion in the past. A sober view
reveals today, as it did in the late 1980s, that “with political will, however, governments can adopt more
flexible approaches by planning CHW programmes within the context of overall health sector activities,
rather than as a separate activity. Weaknesses in training, task allocation and supervision need to be
addressed immediately. CHWs represent an important health resource whose potential in providing and
extending a reasonable level of health care to undeserved populations must be fully tapped” (Gilson et al.,
1989).Social Work & Role of Health Promotion Specialist Essay
As a community development worker, you’ll help communities to bring about social change and improve the quality of life in their local area. You might work with individuals, families or whole communities, empowering them to:
identify their assets, needs, opportunities, rights and responsibilities
plan what they want to achieve and take appropriate action
develop activities and services to generate aspiration and confidence.
Community development workers act as the link between communities and a range of other local authority and voluntary sector providers, such as the police, social workers and teachers.
You’ll frequently be involved in addressing inequality. Projects often target communities perceived to be culturally, economically or geographically disadvantaged.
Responsibilities
Community development work seeks to actively engage communities in making sense of the issues which affect their lives, setting goals for improvement and responding to problems and needs through empowerment and active participation.Social Work & Role of Health Promotion Specialist Essay
A good deal of the work is project based, which means you’ll usually have a specific geographical community or social group to focus on.
Tasks often involve:
identifying community skills, assets, issues and needs
ensuring that local people have their say
developing new resources in dialogue with the community and evaluating existing programmes
building links with other groups and agencies
helping to raise public awareness on issues relevant to the community
preparing reports and policies
raising and managing funds
developing and implementing strategies
liaising with interested groups and individuals to set up new services
mediating in matters of conflict
recruiting and training paid and voluntary staff
planning, attending and coordinating meetings and events
overseeing the management of a limited budget
encouraging participation in activities
challenging inappropriate behaviour
general administrative duties.
Community work can be generic or specialised. Generic community work takes place in a particular geographical area, focusing on working with the community to identify their needs and issues, and formulating strategies to address those issues. The setting is either urban or rural, with rural community development work increasingly attracting attention.Social Work & Role of Health Promotion Specialist Essay
Specialised community work focuses on either specific groups within a region (such as the homeless, the long-term unemployed, families with young children or ethnic minorities), or on particular concerns such as:
mental health
public transport
tackling drug abuse.
Salary
Starting salaries fall between £15,500 and £26,000.
Salaries for those with two or more years’ experience can reach £21,000 to £36,000.
For public sector posts, there are national pay scales and sometimes an allowance is awarded as compensation for unsocial hours.
In the voluntary sector, pay varies considerably and often depends on experience and location.
Income figures are intended as a guide only.
Working hours
Each working day will vary depending on your scheduled activities for that week. You need to be accessible to the communities you serve. This means the work will often include unsocial hours, such as evenings and weekends, so considerable flexibility is required.
Part-time, temporary work and career breaks are possible. Short-term contracts are common, due to the nature of funding within the sector.Social Work & Role of Health Promotion Specialist Essay
What to expect
Community development workers often have an office base but spend much of their time out and about in the community, visiting local people and groups and attending meetings.
Self-employment or freelance work is sometimes possible, working as a trainer or consultant.
The work is usually either urban or rural based, and conditions vary according to the nature and location of the project and funding. Large towns and inner city areas with recognised social deprivation are more likely to receive sustained funding. However, the number of rural community development workers is steadily increasing as recognition of social issues affecting rural communities grows.
Coping with social disadvantage and disaffected members of the community can be stressful.
There is frequent contact with individuals, agencies and groups in the community. Therefore, travel within a working day is to be expected. Absence from home overnight is unlikely but may be required on occasion. Depending on the employer, it may be possible to travel overseas.Social Work & Role of Health Promotion Specialist Essay
Related case studies
Heather Swadley
Caseworker at the House of Commons
Qualifications
Although this area of work is open to all graduates and those with any HND, a qualification in a social sciences subject may improve your chances.
Entry without a degree or HND is possible, although career development is more restricted. A degree in any subject will be an advantage in gaining higher-level posts. In community development, relevant experience is far more important than the subject area studied.
A variety of vocational college or work-based training courses and undergraduate and postgraduate university courses are available throughout the UK.
Before being allowed to work directly with children or vulnerable adults, employees in England and Wales will be required to undergo a Disclosure and Barring Service (DBS) check.Social Work & Role of Health Promotion Specialist Essay
Community development workers in Scotland will need to join the Protecting Vulnerable Groups Scheme (PVG). In Northern Ireland, you’ll need to be checked by AccessNI.
For some positions, postgraduate qualifications are essential in order to progress to more senior-level positions. This is particularly true in generic community work. A variety of full-time and part-time courses are available, with some open to those with an HND. One or two years’ relevant experience is usually required.
Community development is often linked to youth work and many training courses will reflect this. Youth work is more specialised and often involves a different agenda than community development work. For further information on courses in youth work, see the National Youth Agency (NYA).
For information on youth work and youth work training in Wales, Scotland and Northern Ireland, contact:Social Work & Role of Health Promotion Specialist Essay
ETS Wales
Standards Council for Community Learning and Development (CLD) for Scotland
Youth Council for Northern Ireland (YCNI)
Scottish courses (and a few in other locations) often refer to community development as community education.
Skills
You’ll need to show:
advocacy and networking skills
excellent communication, interpersonal and team building skills
good listening skills
research and report-writing skills, and the ability to interpret or present data
knowledge and understanding of community and social issues
a non-judgemental and positive attitude
creative thinking and problem-solving ability
political, social and negotiating skills
an understanding of how public sector bodies work
compassion and the ability to empathise with people’s life experiences
fundraising – at management level there is an increasing need to identify and pursue sources of funding.
Community work is challenging, exciting and at times frustrating. You need to be prepared to cope with inevitable conflict and setbacks. Results are long term rather than immediate, so patience and perseverance are essential.Social Work & Role of Health Promotion Specialist Essay
Close involvement with the community group can deepen your empathy, your sense of identification and commitment, but at the same time you need to be able to switch off from your work. Tact and diplomacy are essential for negotiating your entry into a community.
The strong commitment to equal opportunities within the public sector creates a demand for ethnic minority applicants. Life experience and language skills can also be factored into the application process.
Work experience
Pre-entry paid or voluntary work experience is crucial. People often become community development workers after working in teaching, youth work, the health sector or other roles within the community. Development work overseas may also be relevant.Social Work & Role of Health Promotion Specialist Essay
It’s important to have a proven interest in community and social issues and at least a year’s involvement in a relevant area, including:
community work
pressure groups
women’s projects
youth work.
Try to get involved in voluntary work as a student, in local community projects, youth groups, tenants’ associations or women’s groups. Contact your local volunteer centre to get community-project experience. You can search for your nearest branch, or your region’s equivalent via Do-it.
Competition for jobs is keen, especially for the limited number of local authority posts, which often offer greater job security. Competition is affected by the political climate, current issues (such as unemployment and immigration) and the identification of groups within the community that need particular support.Social Work & Role of Health Promotion Specialist Essay
Advertisement
Employers
The most common employers of community development workers are:
community education organisations
housing associations
local authorities
NHS trusts
rural community councils
social services
voluntary sector organisations.
With reduced state provision (e.g. reduced benefit entitlement for young people, care in the community and general socioeconomic changes), the need for community development workers has increased.
The shift in recent years from central-government funding to project-based funding, distributed by rounds of bidding, has led to an increase in workers employed on a short-term basis by voluntary sector organisations.
There are signs that central government is looking toward the voluntary unpaid sector for managing community projects and this might affect future funding.Social Work & Role of Health Promotion Specialist Essay
Organisations within the voluntary sector are varied and include:
children’s charities
churches and other faith groups
community associations
environmental groups
health and mental health organisations
homeless projects
shelters
women’s groups.
Because of the broad remit of community work, a community development worker could be employed by any of these organisations doing different types of work.
Look for vacancies at:
The Big Issue
Goodmoves
jobsgopublic
Local Government Jobs
Third Sector Jobs
You can also check regional and local press and local authority vacancy bulletins for opportunities.
Specialist recruitment agencies handle vacancies but many community organisations would not use employment agencies on ethical and/or cost grounds.
Professional development
Ongoing training is essential in community work and usually occurs on the job or as part-time study to gain a recognised qualification.Social Work & Role of Health Promotion Specialist Essay
Since projects and communities vary so much, community development workers must constantly develop new skills, update old ones and acquire specific knowledge. Training provision varies depending on the employer, but there are likely to be opportunities to develop relevant skills.
The voluntary sector is especially rich in interesting and relevant training opportunities, including accredited training programmes available at colleges and other learning centres.
It is possible to take National Open College Network (NOCN) Awards and Certificates or Scottish Vocational Qualifications (SVQs) in community development.
Social services and other organisations employing community development workers often offer programmes of in-house training, which usually focus on issues such as child protection and equal opportunities.
It’s also quite common for community development workers to pursue their own continuing professional development (CPD) by undertaking a Masters degree or other postgraduate qualifications. Relevant subjects include:Social Work & Role of Health Promotion Specialist Essay
business and community studies
housing practice
legal studies
public health or community health
social services management
voluntary sector studies.
Career prospects
Opportunities for promotion are limited in both the public and voluntary sectors, and you may have to move to another geographical area.
Sideways movement into projects with a different focus, or from generic to specific work (or vice versa), is common. Senior posts usually involve managing more staff, a larger budget or a wider geographical area.
As community development workers embark on postgraduate study, there is the tendency to move into more policy-making positions, with a view to becoming directors of organisations with responsibility for implementing large-scale and complex projects.Social Work & Role of Health Promotion Specialist Essay
With substantial experience and expertise in a specific field, there is the possibility of freelance work in the role of a trainer, consultant or adviser. Due to the broad nature of community work, workers can develop their careers by moving into other fields such as:
education
environment
health sector
social work
youth work.
Opportunities also exist for overseas development work – for more information see the International Association for Community Development (IACD). Social Work & Role of Health Promotion Specialist Essay
