Health Policy

Challenges to Peer Support in LMIC During COVID-19

Global Health. 2020 Sep 25;16(1):90. doi: 10.1186/s12992-020-00622-y. [Full Commentary]

Mpango R, Kalha J, Shamba D, Ramesh M, Ngakongwa F, Kulkarni A, Korde P, Nakku J, Ryan GK

Abstract

Background: A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions…

Toward an institutional perspective on social capital health interventions: lay CHWs as social capital builders

Sociol Health Illn. 2020 Jan;42(1):95-110. doi: 10.1111/1467-9566.12992. Epub 2019 Nov 1. [Pubmed Abstract]

Adams C

Abstract
This article argues that social capital health research should move beyond a mere focus on social cohesion and network perspectives to integrate an institutional approach into the development of social capital health interventions. An institutional perspective, which is unique in its emphasis on linking social capital in addition to the bonding and bridging forms, contextualises social capital, allowing researchers to confront the complexity of social relationships. This perspective allows for the construction of interventions that draw on the resources of diverse actors, particularly the state. One intervention strategy with the potential to create community linkages involves lay community health workers (LCHWs), individuals who are trained to perform a variety of health-related functions but lack a formal professional health education. This article…

Realizing the Value of CHWs — New Opportunities for Sustainable Financing

N Engl J Med. 2019 May 23;380(21):1990-1992. [Pubmed Abstract]

Lapidos A, Lapedis J, Heisler M

Health care financing in the US, especially since the passage of the Affordable Care Act (ACA) or “Obamacare,” has increased opportunities for financing peer support and community health worker (CHW) programs.  In this week’s Tuesday Tip, our colleague, Michele Heisler, and two of her other colleagues from the University of Michigan, Adrienne Lapidos and Jeremy Lapedis outline the case for routine financing of CHWs and several possible mechanisms and paths to accomplish this.

Opportunities include 2018 Medicare provisions to cover CHW and other nonmedical benefits especially for those with chronic diseases.  This follows earlier Medicaid provisions included in the ACA to cover CHW and other supportive services for those with mental health and chronic conditions.  Medicaid has also updated rules to encourage Medicaid MCOs to cover services including those addressing social…