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5-SPICE framework

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The 5-SPICE framework is an instrument designed for global health practitioners to guide discussions about community health worker (CHW) projects.[1]

The 5-SPICE framework was developed by clinicians and researchers from Partners In Health, Harvard Medical School, and Brigham and Women’s Hospital in Boston, MA.[2] The framework lays out a model for integrating community health workers into public health systems, learning from the experiences Partners In Health and partner organizations at their project sites in resource-poor settings around the world.[3] 5-SPICE draws upon experiences from Haiti, Rwanda, Lesotho, Liberia, Nepal, Mali, and elsewhere, where CHWs have been employed to improve patient outcomes and overcome personnel shortages.[4] The framework allows for all stakeholders in a community health program to participate in discussions and analyses to strengthen the impact of CHWs.


5-SPICE allows for all stakeholders in a community health program to participate in discussions and analyses to strengthen the impact of CHWs.

The name 5-SPICE is derived from Chinese cuisine emphasizing the balance between inputs and elements. The five main elements form an acronym:

  • Supervision (especially management plans and structures)
  • Partners (especially ownership and stewardship)
  • Incentives (part of the larger theme of motivation)
  • Choice (how CHWs are recruited to work and why they take the job)
  • Education (what CHWs bring to their job and how they are trained) [2]

These elements are not a static list, but a way to holistically analyze how core programmatic elements affect each other in the field. In the Freirean tradition of awareness, the 5-SPICE model emphasizes facilitated discussion and contemplation among stakeholders, particularly CHWs, to maximize program outputs. Ultimately, the 5-SPICE framework allows program implementers to study the relationship between the health system and the local community.

Other CHW program frameworks exist, such as the USAID Assessment and Improvement Matrix.[5] 5-SPICE complements these other frameworks by providing an acronym that condenses the many elements discussed in other frameworks into an easy-to-remember heuristic, allowing for more effective and efficient assessments that are exploratory rather than prescriptive.

The 5-SPICE framework was first formally introduced in an April 2013 publication in Global Health Action, in an article entitled “5-SPICE: the application of an original framework for community health worker program design, quality improvement and research agenda setting.”[2] The framework was subsequently presented at the 2013 Consortium of Universities for Global Health Conference[6] , and the 2013 Swedish Society of Medicine’s annual conference, Global Health—Beyond 2015[7] . The article has also been accepted for presentation at the 2013 Annual Meeting of the American Public Health Association.[8]

References

  1. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 23561023, please use {{cite journal}} with |pmid=23561023 instead.
  2. ^ a b c Palazuelos, Daniel (April 3). "5-SPICE: the application of an original framework for community health worker program design, quality improvement and research agenda setting". Global Health Action. 6. doi:10.3402/gha.v6i0.19658. Retrieved 17 July 2013. {{cite journal}}: Check date values in: |date= and |year= / |date= mismatch (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  3. ^ "Community Health Workers". Partners In Health. Retrieved 19 July 2013.
  4. ^ "Our Work". Partners In Health. Retrieved 19 July 2013.
  5. ^ "Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving CHW Programs and Services". USAID. Retrieved 19 July 2013.
  6. ^ "5-SPICE: An Original Framework for Community Health Worker Program Design, Quality Improvement and Research Agenda Setting". Consortium of Universities for Global Health. Retrieved 17 July 2013.
  7. ^ "Beyond 2015". Swedish Medical Society. Retrieved 17 July 2013.
  8. ^ "A unique non-linear chw program framework for quality improvement". APHA. Retrieved 19 July 2013.
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