ChW

CHW stands for community health worker, a frontline public health worker who is a member of the community served and shares its language and culture. CHWs act as a bridge between communities and formal health systems, delivering basic care, health education, screening, and social support, and helping people navigate services.

Common roles include health promotion, disease prevention, maternal and child health, immunization support, adherence to treatment, nutrition and sanitation, mental health support, and referrals to clinics. They often provide home visits, accompany patients to appointments, and assist with community mobilization for vaccination campaigns. CHWs emphasize culturally appropriate communication and trusted relationships to encourage healthy behaviors and timely care-seeking.

Training and regulation vary widely. Some CHWs undergo short, informal training; others receive formal certification and ongoing supervision. They are frequently recruited from the communities they serve and may be remunerated or volunteer. CHWs work under the oversight of health ministries, non-governmental organizations, or primary health centers, and their activities are typically integrated into broader primary health care and public health programs.

Impact and policy: numerous studies indicate CHWs can improve access to care, increase preventive service uptake, support treatment adherence, and reduce barriers for marginalized groups. They are viewed as vital to achieving universal health coverage and stronger health systems. Notable programs include India’s Accredited Social Health Activist (ASHA) program; similar cadres exist in many countries. Evidence supports cost-effectiveness when CHW programs are well-supported, supervised, and properly integrated.

Challenges include sustainable funding, fair compensation, quality supervision, safety, clear scope of practice, data privacy, and career progression. Successful CHW programs require robust governance, training standards, and ongoing evaluation.