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Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving CHW Programs and Services


Topics: CHW role, Community and home-based care for PLWHA, Community health workers, Directly observed treatment, DOTS, HIV/AIDS, Maternal, Newborn and Child Health, Motivation/incentives, Performance management, Recognition/remuneration, Recruitment, Retention of health workers/reducing attrition, Social mobilization, Supervision, Task definition, Task shifting, TB case management, TB-HIV, Training, Tuberculosis


A key element of USAID’s strategic approach to maternal and child health (MCH) is to increase the number of functional community health workers serving in USAID priority countries by at least 100,000 by 2013. At the request of the USAID MCH team, the Health Care Improvement Project (HCI) developed a tool that defines a set of key elements needed for community health worker programs to function effectively and that evaluate programs on specific criteria, which were defined by recent literature reviews on CHW programs (see link below) and by suggestions from experts. The CHW Program Assessment and Improvement Matrix (CHW AIM) tool examines 15 programmatic components that are critical to successfully supporting CHWs. These include: recruitment; the role of CHWs; initial and continuing training; equipment and supplies; supervision; individual performance evaluation; incentives; community involvement; referral system; opportunity for advancement; documentation and information management; linkages to the health system; program performance evaluation; and community ownership. 

By applying the tool, each of the above components is rated with a four-point scale ranging from non-functional to highly functional. In addition to assessing the functionality of CHWs, the tool includes lists of high impact, evidence-based interventions for MCH and HIV/TB services to guide the assessment of current CHWs services.
The instrument is applied through participatory methods with stakeholders to assess the status of a specific program and determine the level of program and CHW functionality. Additionally, the tool provides guidance for action planning and additional resources to assist program managers in strengthening their community health worker programs.
Download the complete CHW AIM toolkit  and a powerpoint presentation for training facilitators to apply the CHW AIM from the Links below.  The CHW AIM Toolkit and training presentation are also available in French and Spanish at the Links below.
Sections IIIA (CHW MNCH Interventions), IIIB (CHW HIV/AIDS Interventions), IIIC (CHW TB Interventions), IV (CHW AIM Facilitator's Guide) and V (Curriculum for Training of Facilitators to Use the CHW AIM Toolkit) may also be downloaded separately from the Links below.
For convenience, Appendices 1-6 of the toolkit, which contain forms for the actual application of the assessment and improvement process, are provided below as separate attachments to allow users to download only specific forms.  Appendix 5 is also provided in Microsoft Excel, and Appendix 6 is also provided in Microsoft Word.   A brief review of recent literature on CHWs that influenced the development of the tool is also provided below at the end of the list of attachments.
CHW AIM Appendix1_Participant Selection Form.pdf280.43 KB
CHW AIM Appendix2_Document Review Guide and Checklist.pdf279.2 KB
CHW AIM Appendix3_Validation Questionnaire.pdf277.02 KB
CHW AIM Appendix4_Score Documentation Worksheet.pdf241.04 KB
CHW AIM Appendix5_Score and Assessment Sheets.pdf291.88 KB
CHW AIM Appendix A5_revised scoring sheet.xls62 KB
CHW AIM Appendix6_Action Planning Framework.pdf201.64 KB
CHW AIM Appendix A6 Word version.doc33 KB
CHW literature review_Jan2010.pdf139.73 KB