Data Sheet 1_Co-designing PROFESS: a community health worker support framework to strengthen engagement in TB and HIV care in Madagascar.pdf

In Madagascar, approximately 50,720 CHWs serving on a voluntary, unsalaried basis link communities to the formal health system, but only a minority is actively engaged in tuberculosis (TB) or HIV service delivery despite substantial disease burden. This community case study describes a two-stage initiative by a consortium of government disease programmes, an NGO, and an academic partner to strengthen CHW engagement in TB and HIV care in Madagascar.

Stage 1 combined a cross-sectional survey of CHWs across four regions with a nested qualitative component identifying system-level constraints. Stage 2 convened national, sub-national, and community-based stakeholders across sectors in a three-day design-thinking workshop, producing PROFESS, a seven-lever framework operationalised as a guide for strengthening CHW support including concrete measures related to Protection (financial), Recognition, Coordination, Formation (training), Equipment, Supervision, and Security of CHWs.