Why CHWs?
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 several 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 can 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 Workers and trained healthcare professionals.
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 layperson 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 healthcare coverage for hard-to-reach populations.
References
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
