A high level of knowledge about Tuberculosis amongst the Multi-Purpose Workers (MPWs) is the cornerstone for the successful implementation of Directly Observed Treatment Short-course (DOTS) strategy under the Revised National Tuberculosis control Programme of India.
We do not believe, and the experience of Bangladesh and Indonesia seem to confirm, that a high number of community-based, multi-purpose workers can be properly supported and funded to achieve the desired objective.
While 'multi-purpose community workers' can deliver other complementary services such as family planning and other primary health care services, it is not cost effective to produce multi-purpose workers with 'some' midwifery skills.
In the event of scarce resources, however, we support the option of giving priority to quality of care over coverage, offering an adequate number of skilled professionals strongly supported by a well performing system, rather than the option of a high number of multi-purpose workers based in villages without adequate capacity, authority and support.
We hypothesize that a great deal of the stagnation of maternal health programmes has been the result of confusion and careless choices in scaling up between a limited number of truly skilled birth attendants and large quantities of multi-purpose workers with short training, fewer skills, limited authority and no career pathways.
They need to be general-purpose workers who can perform a wide range of tasks: plumbing, painting, repair work, electrical, etc.
Contrary to the statute's original purpose, many workers put in the "salaried" category do little if any supervisory work.
Other staff at block or 'PHC new' level included a block extension educator responsible for information, education and communication (IEC) activities and health programme data, attendants that also dressed wounds and male or female multi purpose health workers (MPHW).
For this purpose, health workers and law enforcement agencies need to understand the scale of the problem through social control and basic surveillance.
Partial integration is characterized by shared responsibilities across providers or through service linkages, and no integration is indicated by single purpose health workers with no linkages to other services.
In Florida, for example, the state categorically eliminated the classification of "independent contractor" in the construction trades, for the purpose of worker's compensation compliance.
