Lay health workers in the classroom in Amazonas, Venezuela.

Project description

Lay health workers (LHWs), who carry out healthcare functions but have no professional healthcare qualifications, are used widely and have the potential to improve vaccination uptake in low and middle income countries (LMICs). However, data on their effects, cost-effectiveness and sustainability is needed.

The aim of the Layvac project is to develop a global knowledge-base on the effects of LHW interventions for vaccination uptake.

Objectives

• To assess the effectiveness of LHWs in improving vaccination uptake and health care delivery and health care outcomes in LMICs.
• To synthesize cost-effectiveness data from randomised controlled trials (RCTs) of LHW programmes to promote vaccination uptake.
• To explore contextual micro- and macro-level factors influencing the effects of LHW interventions to promote vaccination uptake
• To contribute to the development of methods for synthesizing qualitative and quantitative data on the effects of community-based health care interventions
• To identify policy options for the use of LHWs in vaccination programmes and other priority areas across different settings.

Methodological approaches

• Systematic reviews of RCTs of LHW interventions to assess their effectiveness. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases The Cochrane Library, March 17 2010
• Review of cost-effectiveness studies of LHW interventions. Are vaccination programmes delivered by lay health workers cost-effective? Human Resources for Health 2009, 7:81
• Synthesis of qualitative studies to explore factors influencing the effects of LHW programmes
• Case studies of LHW programmes to explore the generalisability of findings
• Narrative synthesis of findings to identify factors influencing the effectiveness of LHW programmes and develop policy recommendations

Case studies of existing LHW programmes include visits to the following LHW programmes

• The Female Community Health Volunteer Programme, Nepal. The female community health volunteer programme in Nepal. Decision makers’ perceptions of volunteerism, payment and other incentives. Social Science & Medicine. March 2010
• The Elim Care Group, South Africa
• Community Agents for Primary Health Care, Venezuela

Funder
Norwegian Research Council

Project team
Claire Glenton, SINTEF
Gloria Azalde, SINTEF
Simon Lewin, Norwegian Knowledge Centre for the Health Services (www.nokc.no)