Evaluation of community health services utilization. A case study from Columbia

In a PHC project in Chocó, Columbia, Community Health Workers (CHWs) were trained in curative care of some simple diseases. Consultations were registered in a village-based monitoring system. Of registered cases, about 60% was treated by CHWs and 15% referred by them. Episodes were underregistered. A cross-sectional survey was carried out in 6 villages, among 890 persons. The CHW was consulted in 6.5% of the cases in which a consultation had been made. This low percentage of consulting the CHW is explained by the lack of perception of all diagnosed morbidity. Reasons for low consultation rates were found in a household survey. Suggestions on improvement of the utilization of CHW services are presented.