A community health working in India speaking to a woman and her daughter
caption Credit: DFID/Lucy Milmo (CC BY 2.0)

Community Health Workers

The Community Health Workers (CHWs) Thematic Working Group (TWG) supports the generation, synthesis and communication of evidence on the roll out and functioning of community health worker programs to enable learning across geographical and political contexts.

National and international decision-makers continue to turn to CHWs to strengthen health systems in the context of achieving universal health coverage and delivery of the Sustainable Development Goals (SDGs) particularly SDG 3 – good health and wellbeing. The interest in CHWs is also increasing across multiple SDGs. CHWs have proven to be instrumental in promoting primary health care in high- and low-income settings, as well as in fragile contexts. The role of CHWs in the current COVID-19 pandemic is unprecedented given their contribution to disease surveillance. Based on the WHO guideline on health policy and systems support to optimize CHW programmes, governments and their partners will further steer improving CHW programmes, including fully integrating them at scale in respective health systems.

Despite this renewed interest in CHW programmes, there is global recognition that more is needed to support CHWs, which in turn can optimise their performance. Many contextual, health systems and programme-related factors play a role regarding the work of CHWs globally. Evidence exists on the research and implementation gaps that need attention if CHW programmes are to be further strengthened. These gaps include: remuneration and incentives, supervision, trust and relationships with the community and other health actors, mental health, CHW roles following health systems shocks, wellbeing of the cadre, and co-production of knowledge with CHWs. Critically, the voices of CHWs in influencing their own work have hardly been heard in many countries. Given the increasing evidence about the factors influencing CHW programmes, as well as concerns around small-scale CHW programmes, more research and cross-national learning is needed on programmes operating at scale under routine conditions. In addition, the voices of CHWs need to be amplified, and they should be considered as key stakeholders in their work. The CHWs TWG brings together academics, policy makers, programme implementers, funders, students, CHWs and other national and international stakeholders to share, explore and understand the existing evidence base, and generate new knowledge to ensure that CHW programmes are accessible, equitable and efficient.

Objectives

  • Raise awareness of the crucial role that CHWs play within the health system.
  • Bring together diverse individuals and networks to share knowledge in a structured and facilitated manner.
  • Convene practitioners and decision-makers in order to better understand the real-world challenges being faced and encourage the use of the existing and emerging evidence base in policy and practice.
  • Promote an institutionalized practice of monitoring interventions and evaluating results by various decision-makers and practitioners.
  • Amplify the voices of CHWs and community groups within these dialogues.

Activities

Key activities include supporting dialogue online, for example, by hosting webinars; organizing biennial international symposia on CHWs; arranging events, for example at the Global Symposium on Health Systems Research; facilitating learning across the group; supporting research; as well as publishing and research translation, which meet the needs of diverse audiences.

Our networks and platforms:

  • CHW Central
    CHW Central is an online community of practice that brings together program managers, experts, practitioners, researchers, and supporters of CHW programs.
  • HIFA (Healthcare Information for All)
    HIFA is a global health network with more than 18,000 members (health workers, librarians, publishers, researchers, policymakers).
  • Community Health Systems Community of Practice
    An ‘open space’ in terms of both contribution and access to knowledge, it aims at gathering practitioners, policymakers, researchers, program implementers and other experts actively involved in the technical or policy development of community health programs in LMICs.
  • Community Health impact Coalition
    The Community Health Impact Coalition exists to make professionalized community health
    workers a norm worldwide.
News and views

News and views

Access the latest blog posts and news items from the Community Health Workers TWG.

Read more

Facilitators

Kingsley Chikaphupha

Kingsley Chikaphupha

Co-Chair

David Musoke

David Musoke

Co-Chair

Faye Moody

Faye Moody

Coordinator

Sarita Panday

Sarita Panday

Coordinator

Kingsley Chikaphupha

Kingsley Chikaphupha

Co-Chair

Kingsley Chikaphupha is a determined young researcher and aspiring consultant devout in service to humanity, passionate for his career, and eager to address new challenges. He is passionate about human resources for health especially CHWs, health systems strengthening, human rights and gender, equity, reproductive health, HIV/AIDS, and the protection of human rights for all. Kingsley holds an MSc in International Public Health from LSTM, UK; BSc in Public Health from Malawi, with over 14 years of experience in research and working with CHWs. He is a Research Coordinator at the Research for Equity and Community Health (REACH) Trust, Malawi.

David Musoke

David Musoke

Co-Chair

David Musoke (BSc, MSc, PhD) is a Lecturer at Makerere University School of Public Health, Uganda. David has carried out vast research among CHWs in Uganda including using photovoice. He has over 60 peer reviewed publications and 80 conference presentations from his research including among CHWs. He is the Uganda lead for the partnership with Nottingham Trent University (UK) that has supported more than 600 CHWs in the country for over 10 years. David spearheaded the 1st International Symposium on Community Health Workers held in Kampala in 2017 that attracted over 450 participants from 22 countries.

Faye Moody

Faye Moody

Coordinator

Faye Moody is an experienced programme Coordinator at Liverpool School of Tropical Medicine. Faye has worked on international CHW projects such as REACHOUT, SQALE. and many other health systems strengthening projects with global partnerships in Africa, South America, and Asia. Faye has an interest in project management, communications and using online platforms and networks for research uptake and knowledge translation.

Sarita Panday

Sarita Panday

Coordinator

Sarita Panday (BSc Nursing, MPH, MHM, PhD), a Global Challenge Fellow at the University of Sheffield, works in collaboration with Kathmandu University in Nepal. She has dedicated her research to improving basic healthcare for the neediest population, especially that of pregnant women and mothers. She received a prestigious 2018-2019 Developing Asia Health Policy Postdoctoral Fellowship at Stanford University, where she worked to publish her work to support CHWs in South Asia. She is currently using participatory research approaches to train community members to improve maternal and child health care among marginalized populations in rural Nepal.

Publications and resources

Community health workers (CHWs) have been shown to play a major role within health systems, especially in fragile and conflict-affected settings (FCAS). This webinar explores: 1. Improved integration between CHW programs and the wider health systems. 2. The flexibility of roles of CHWs in changing contexts. 3. CHW programs in conflict-related contexts need to work in contested political contexts. 4. FCAS may present particular challenges for the mental health of both the population and those providing support, including CHWs.

Community health workers in humanitarian settings: Scoping review

N. P. Miller, F. Bagheri Ardestani, H. S. Dini, et al

There is a need for greater understanding of experiences implementing community-based primary health care in humanitarian settings and of the adjustments needed to ensure continuation of essential services and utilization of services by the population, and to contribute to effective emergency response. The authors reviewed the evidence base on community health workers (CHWs) in humanitarian settings, with the goal of improving delivery of essential services to the most vulnerable populations.

In May 2020, the George Institute for Global Health and the Thematic Working Group on Community Health Workers (CHWs) of Health Systems Global collaborated on a survey to assess the availability of resources that support the mental wellbeing of CHWs in low- and middle-income countries (LMICs) during the COVID-19 pandemic.

Voices from the frontline: The plight of female community health workers in Afghanistan

A. Ahmad Parray, S. Kaufman, Md. I. Khalil Ullah and S. Naseri

The purpose of this blog post is to convey a new understanding of what motivates women to work as CHWs and the experiences and challenges they face, while working in the conflict prone zones of Afghanistan.

This webinar presents experiences and research findings on the role of CHWs as research partners. Sharing evidence from North American and African contexts, it outlines the ways CHWs have been involved in research. Through case examples from Uganda and Liberia, the webinar provides examples and recommendations for engaging CHWs as co-investigators and research partners.

This supplement is constituted of 100 abstracts which were among those presented at the symposium, which was held in February 2017.

The 2nd International Symposium on Community Health Workers brought together over 500 participants from 35 countries to explore the theme: ‘Potentials of CHWs in the prevention and control of Non-Communicable Diseases (NCDs) in the context of Universal Health Coverage (UHC).’