Versatile and often overburdened.  CHWs were explicitly mentioned in the Alma Ata Declaration as cadre to be included as a full partner.  How can CHWs be scaled up and financed in health systems?  What are the pressing research questions?  Are you a CHW?  Share your views and concerns. 

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  • Hi all, a new article is up on our Blog on community-based health workers (CBHWs) and findings on their role in malaria prevention and treatment. This group may be interested. Check out
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    The vision created in the 1978 Alma-Ata Declaration has sustained until today and poignantly sheds light on the future.
  • CHWs are sometimes a victim of their own success. Following increasing visibility from CHW success stories, more health programmes engage CHWs resulting in a broader scope of work and consequently an overburdened CHW. Worse still is the nominal pay for the significant changes in their job description.
    To scale up CHW programmes, there is a need to integrate them into the formal health system. However, the lack of shared understanding on CHWs, their level of education and roles makes it difficult. There is a need for a locally and globally relevant categorization of CHWs (competency- based) that will guide role assignment within a multidisciplinary health team, remuneration and additional training. More so, other members of the health team such as doctors and nurses have such structured categories.
    Furthermore, integration of CHWs into the formal health system makes it easier for the government to coordinate the pooling and utilising the multiple fund sources such as NGO funds targeting CHW activities.
  • In the US context, CHWs seem to be specialized. They have clear roles on the Team. However, that results in there being less identitification with the overarching role as a CHW.
    • Reading the articles by Henry Perry's group reviewing evidence on CHWs (e.g., makes me think a lot of CHWs get specialized and deployed in vertical programs. That isn't bad, it is recognition that CHWs can be a useful tool for progress. PHC would commit us to having more systematic availability and deployment of CHWs.
      Comprehensive review of the evidence regarding the effectiveness of community–based primary health…
      As part of our review of the evidence of the effectiveness of community–based primary health care (CBPHC) in improving maternal, neonatal and child h…
  • I am curious to hear how things went at the Geneva Health Forum. Did issue of CHWs come up at all? If so, what are the main take away messages?
  • The experiences of Ethiopia in successfully using CHWs to increase access under their health extension program is particularly interesting. I would love to hear more from the colleagues at the International Institute for Primary Health Care in Ethiopia. Uganda is trying to scale up CHWs under the village health teams (VHT) programme. Could colleagues in Uganda provide some insights into how this programme is working (or not working)? What are some success factors, enabling factors, policy constraints, etc?
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