Abstract
The recent WHO guidelines for optimising community health worker (CHW) programmes in health systems (December, 2018) are a welcome addition to the discourse on the contribution of CHWs to universal health coverage (UHC). These guidelines formalise the view that CHWs are a core component of expanding access to health care, while recognising that CHWs too often remain sidelined by the general health system. CHWs need to be integrated into the health workforce if the aspiration of UHC is to be realised; however, the overall quality of care delivered by CHW programmes is variable across settings.
Highlights
The missing piece: A focus on optimising community 4 National Academies of Sciences, Engineering, quality in community health programmes health should be an integral part of the broader discourse on the quality of health care
CHWs will improve the efficiency and need to be integrated into the health efficacy of referrals. This integration workforce if the aspiration of UHC is to will help health systems to shift be realised; the overall quality their focus from reactive curative of care delivered by CHW programmes care to more proactive health is variable across settings
There remains a *Vicki Doyle paucity of quality improvement vdoyle@capacity-development.com models applied to community health, LVCT Health, Nairobi, Kenya (LO);Amref Health and existing approaches are geared towards facility-based health care
Summary
The missing piece: A focus on optimising community 4 National Academies of Sciences, Engineering, quality in community health programmes health should be an integral part of the broader discourse on the quality of health care. Crossing the global quality chasm: improving health care worldwide. CHWs are addition to the discourse on the in a unique position to amplify the contribution of CHWs to universal voices of the vulnerable and to ensure health coverage (UHC).
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