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With the overall aim of identifying community health worker (CHW) programs with positive impact on Millennium Development Goals (MDGs) related to health or otherwise, this global systematic review was undertaken of such interventions, as well as eight in-depth country case studies in Sub-Saharan Africa (Ethiopia Mozambique and Uganda), South East Asia (Bangladesh, Pakistan and Thailand) and Latin America (Brazil and Haiti).

This study evaluates the health impacts of a volunteer intervention addressing health worker shortage in remote mountainous communities of Vietnam. [from abstract]

This paper investigates the role of various healthcare providers in provision of health services in a remote rural area in Bangladesh. [from abstract]

This study assessed community acceptability of the use of rapid diagnostic tests by Ugandan community health workers, locally referred to as community medicine distributors. [from abstract]

This article investigated the reasons for the high rates of community health worker attrition in Bangladesh. [adapted from abstract]

Ethiopia’s health extension workers (HEW) deliver preventive interventions and treat childhood diarrhea and malaria, but not pneumonia. Most of Ethiopia’s annual estimated 4 million childhood pneumonia cases go untreated. The purpose of this study was to evaluate the performance of volunteers in providing community case management for diarrhea, fever and pneumonia in a pre-HEW setting in Ethipia. [adapted from abstract]

This qualitative paper reports on the experience of three community health worker (CHW) supervisors who were responsible for supporting infant feeding peer counsellors. The findings highlight the complexities of supervising and supporting CHWs. [adapted from abstract]

This report outlines a training program for health extension workers in long-acting family planning methods in Ethiopia.

Lay or community workers can be a valuable resource in response to the human resource crisis in many low- and middle-income countries. Successful interventions by lay health workers have led to improvements in maternal and child health, including reductions in mortality and morbidity from common childhood illnesses, and effective support to people receiving treatment for tuberculosis. [from author]

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

The objective of this document was to conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. [from abstract]

In rural settings, the promotion of household and community health practices through community health workers (CHWs) is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child health services in rural Mali. [from abstract]

This report presents research findings on the potential for making contraceptives, and in particular injectable contraceptives, widely available through using a community-based distribution approach which would expand the cadre of providers authorized to provide contraceptives to include health surveillance assistants and community-based distribution agents. [adapted from summary]

This paper reviews the costs and cost-effectiveness of vaccination programme interventions involving lay or community health workers. [from abstract]

The policy framework is intended to provide an effective and efficient occupational workforce to support a comprehensive multidisciplinary health care service; strengthen partnerships between government, civil society and communities to consolidate, manage and focus the services offered by Community Care Workers; and delineate strategies that address systemic change within the complex systems both within the public sector and its partners. [from introduction]

This paper provides a participant-observer perspective of the evolution of community health workers from vertical and isolated activities for TB, HIV and other specific diseases to an integrated community health team approach for tackling the main disease burden in a rural district of Mozambique. [from introduction]

The goal of this paper is twofold. It uses the recent experience of Brazil’s Family Health Program to assess the effectiveness of community based health interventions as instruments for improvements in health conditions in less developed areas. It also evaluates whether the health improvements associated with the program also brought about the changes in household behavior predicted by economic theory and noticed in other contexts. [adapted from author]

Because of increased demand for injectable contraception coupled with an overburdened clinical health system, countries, particularly in sub-Saharan Africa, have recently expanded the use of non-clinic based approaches in providing this method. In this first review of the available evidence of these efforts, this consultation concluded that there is sufficient evidence to support expansion of community-based health workers providing progestin-only injectable contraceptives, especially DMPA. [from author]

This study sought to gain understanding of the motivations of community service (CS) officers to continue working at the same district hospital for a subsequent year after their obligatory year was over. The objectives were to determine the number of CS officers who actually remained at the same district hospital after completing their CS in 2002, the major factors that influenced them to remain and factors that would encourage the 2003 cohort of CS officers to remain at the same district hospital for an additional year. [from abstract]

This article reports on the obstacles to care and the outcome of treatment for patients presenting with tuberculosis to four hospitals in the rural South African region of Sekhukhuneland. [adapted from article]

We conducted this study to document the perceptions of community health workers in Pakistan on their knowledge and communication needs, image building through mass media and mechanisms for continued education. [adapted from abstract]

This article offers an analysis of the role community health worker programs and activities in South Africa. [adapted from introduction]

This report provides an overview of paid healthcare workers in Tanzania.

This paper discusses the role and impact of community health workers in Nyanza Province, Kenya, in response to the growing demands the HIV epidemic has placed on the people and communities in this region. [adapted from abstract]

The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. [from abstract]

With the scarcity of African health professionals, volunteers are earmarked for an increased role in HIV/AIDS management, with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS - as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. [from abstract]

Currently, a wide variety of community health workers are active in many antiretroviral treatment delivery sites. This article investigates whether present community health worker programmes for antiretroviral treatment are taking into account the lessons learnt from past experiences with community health worker programmes in primary health care and to what extent they are seizing the new antiretroviral treatment-specific opportunities. [from abstract]

This document provides resources on Ethiopia’s experiences with community health worker programs. [from abstract]