Close-to community providers and health systems: what are the implementation challenges and how can we overcome them?


On Wednesday at the HSR2014-conference KIT facilitated a session together with REACHOUT colleagues on what can be done to improve the performance of close-to-community (CTC) health providers.

After a presentation of the findings of the context analysis in 6 countries by KIT Health advisor Korrie de Koning, there were 3 discussion groups in a World Café setting.

The following  topics were discussed:

  • supervision;
  • coordination
  • referral.

The discussions not only focused on problems regarding these topics, but primarily focused on good examples of interventions that have worked to improve supervision , coordination of referral in CTC programmes.

The session was attended by about 40 participants. A report on the discussions will be available soon. REACHOUT will use all input in shaping the interventions that are going to take place in 6 countries, in order to improve the performance of CTC providers, finally contributing to efficient and equitable community health services.

Some quotes from participants:

“ In Thailand, there is much political commitment and the referral system has improved because of this. CTC providers should be recognized at the heart of the health system”.

 “We assume that supervision will happen without planning and paying for it. Supervisors have to feel that they are also accountable for the well-being of the clients, it cannot be solely the CTC provider to feel this burden..”

“Coordination is vital, otherwise CTC providers are lost by the number of supervisors, in addition to the high workload they already have. We need leadership..”