![]() ![]() There have been different attempts to define and categorise CHWs based on their roles, educational level, and remuneration. Other CHWs undergo formal training in nationally recognised training institutions with structured training content and duration. Some CHWs undergo informal training, with varied training content and durations, taking place outside recognised training institutions. Furthermore, in contrast to professional health workers, there is remarkable diversity in the content and duration of CHWs’ training. However, the diversity of roles and inconsistent nomenclature of CHWs make it difficult for policy makers, programme planners, and researchers working with CHWs in different settings to have a common understanding of ‘who is a CHW?’. Įvidence suggests that the presence of community health workers (CHWs) can complement an overstretched health workforce and may be key to increasing the availability of, and access to, basic health services especially in hard-to-reach areas, thereby bridging the health equity gap. ![]() The magnitude of the health workforce shortage varies across contexts with rural regions and low- and middle-income countries being the worst affected, and with critical shortages greatest in sub-Saharan Africa. A decade ago, the World Health Organization (WHO) declared a crisis in the global health workforce, characterised by severe shortages, inappropriate skill mixes, and gaps in service coverage. To achieve the health-related Sustainable Development Goals (SDGs) and universal health coverage (UHC) in the post-2015 period, adequate numbers of competent health workers are required to provide services in an enabling environment. Lay health workers tend to provide basic health services as unpaid volunteers while level 1 paraprofessionals often receive an allowance and level 2 paraprofessionals tend to be salaried.Ĭonclusions: This review provides a categorisation of CHWs that may be useful for health policy formulation, programme planning, and research. These are lay health workers (individuals with little or no formal education who undergo a few days to a few weeks of informal training), level 1 paraprofessionals (individuals with some form of secondary education and subsequent informal training), and level 2 paraprofessionals (individuals with some form of secondary education and subsequent formal training lasting a few months to more than a year). CHWs can be categorised into three groups by education and pre-service training. The review shows CHWs as paraprofessionals or lay individuals with an in-depth understanding of the community culture and language, have received standardised job-related training of a shorter duration than health professionals, and their primary goal is to provide culturally appropriate health services to the community. Results: We identified 119 papers that provided definitions of CHWs in 25 countries across 7 regions. Objective: To identify the common themes in the definitions and descriptions of CHWs that will aid delineation within this cadre and distinguish CHWs from other healthcare providers.ĭesign: A systematic review of peer-reviewed papers and grey literature. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. Background: Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. ![]()
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