Community health workers at the dawn of a new era: 5. Roles and tasks

Claire Glenton,Henry B Perry,Dena Javadi

doi:10.1186/s12961-021-00748-4

Abstract

BackgroundThis is the fifth of our 11-paper supplement on “Community Health Workers at the Dawn of a New Era.” When planning new community health worker (CHW) roles or expanding existing roles, programme planners need to analyse global and local research evidence and evidence-based guidance on the effectiveness and safety of relevant tasks performed by CHWs.MethodsIn this paper, we explore key areas of consideration when selecting roles and tasks; present current knowledge regarding these issues; and suggest how decision-makers could consider these issues when assigning tasks in their setting. This paper draws on the chapter “Community Health Worker Roles and Tasks” in Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers, as well as on a recently published compendium of 29 case studies of national CHW programmes and on recently published literature pertaining to roles and tasks of CHWs.ResultsThis paper provides a list of questions that aim to help programme planners think about important issues when determining CHW roles and tasks in their setting. Planners need to assess whether the recommended roles and tasks are considered acceptable and appropriate by their target population and by the CHWs themselves and those who support them. Planners also need to think about the practical and organizational implications of each task for their particular setting with regard to training requirements, health systems support, work location, workload, and programme costs.ConclusionWhen planning CHW roles and tasks, planners, programme implementers, and policy-makers should draw from global guidance and research evidence, but they also need to engage with the experiences, needs, and concerns of local communities and health workers. By drawing from both sources of information, they will stand a better chance of developing programmes that are effective in achieving their goals while remaining acceptable to those affected by them, feasible to implement, and sustainable over time.

Highlights

This article provides a list of 10 questions that can help programme planners think about important issues when determining community health worker (CHW) roles and tasks:
Large-scale community health worker (CHW) programmes may be at the threshold of a new era
Instead of being seen as a temporary, second-class solution to problems that will gradually go away, CHW programmes are increasingly seen as an important health systems anywhere for the long term

Summary

Introduction

Large-scale community health worker (CHW) programmes may be at the threshold of a new era. Instead of being seen as a temporary, second-class solution to problems that will gradually go away, CHW programmes are increasingly seen as an important health systems anywhere for the long term. CHWs are increasingly recognized as potential providers of services tied to noncommunicable diseases (NCDs) [3] such as hypertension [4], diabetes [5], cancer screening [6–8], and mental health [9]; as well as services tied to environmental health [10], digital health [11], and humanitarian events [12, 13]. This interest has increased in the face of the coronavirus disease 2019 (COVID-19) pandemic [14]. This is the fifth of our 11-paper supplement on “Community Health Workers at the Dawn of a New Era.” When planning new community health worker (CHW) roles or expanding existing roles, programme planners need to analyse global and local research evidence and evidence-based guidance on the effectiveness and safety of relevant tasks performed by CHWs

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Conclusion