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

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


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.
The CHW AIM tool, a brief review of recent literature on CHWs that influenced the development of the tool, and individual forms that include comprehensive lists of maternal, newborn and child health, and HIV/AIDS tasks that relate to CHWs can be downloaded below.  A powerpoint presentation for training facilitators to apply the CHW AIM toolkit is also provided below.
Please note that the first file below contains ALL of the pieces of the CHW AIM toolkit.  For convenience, Appendices 1-6 of the toolkit, which contain forms for the actual application of the assessment and improvement process, are provided as separate files to allow users to download only specific forms.
CHW AIM Toolkit_March2011.pdf1.81 MB
CHW literature review_Jan2010.pdf139.73 KB
CHW AIM A1_Participant Selection Form.pdf280.43 KB
CHW AIM A2_Document Review Guide and Checklist.pdf279.2 KB
CHW AIM A3_Validation Questionnaire.pdf277.02 KB
CHW AIM A4_Score Documentation Worksheet.pdf241.04 KB
CHW AIM A5_Score and Assessment Sheets.pdf291.88 KB
CHW AIM A6_Action Planning Framework.pdf201.64 KB
Copy of CHW AIM Appendix A5.xls39 KB
CHW AIM Appendix A6.doc33 KB
CHW AIM Trainers Guide slides.ppt2.4 MB