Community Health Workers’ Roles in the Medical System of Developing Nations

Community Health Workers (CHWs) hold a unique role within the public health and medical systems. They provide a wide range of services and assist with a number of public health programs around the world. Many CHWs in the United States and high-income countries act as health promoters, educating community members about health-related topics.¹ CHWs have an in-depth understanding of their communities, and they are able to engage community leaders and members and spread public health messages in a culturally acceptable manner. In this context, CHWs serve a supporting role to well-established medical and public health systems, and it is easy to imagine a sharp distinction between community health worker and trained healthcare professional.

In contrast, CHWs in developing nations often complement overstretched healthcare systems, and provide a wide variety of primary healthcare services.² The type and complexity of these services as well as incentives and pay will vary widely depending on location and level of education attained by the CHW.² This can blur the distinction between a lay person volunteering and a healthcare professional providing a service as a career. A systematic review of research on community health workers found that CHWs could be generally classified into three levels from lay people with informal training to “paraprofessionals” with in-depth training.² Each level has different roles within the healthcare system, but the authors note there is a lot of evidence that all levels of CHWs contribute to increasing healthcare coverage.² This shows that pinpointing the exact role of the CHW in the medical system of developing nations is difficult, but training CHWs is nonetheless a worthwhile global health project to increase the healthcare coverage for hard-to-reach populations.

1. Malcarney, M. B., Pittman, P., Quigley, L., Horton, K., & Seiler, N. (2017). The Changing Roles of Community Health Workers. Health services research, 52 Suppl 1(Suppl 1), 360–382. https://doi.org/10.1111/1475-6773.12657

2. Olaniran, A., Smith, H., Unkels, R., Bar-Zeev, S., & van den Broek, N. (2017). Who is a community health worker? – a systematic review of definitions. Global health action, 10(1), 1272223. https://doi.org/10.1080/16549716.2017.1272223