To harness the potential of community health workers (CHWs) to extend health services to poor and marginalized populations and avoid the pitfalls of the post-Alma-Ata period, there is an urgent need to better understand how CHW programs can be optimized. Rigorous evidence that CHW care delivery can improve access to care and reduce mortality continues to accumulate, but the most recent evaluations of national-scale CHW programs remain unfavorable. CHWs can contribute to advancing universal health coverage, but only if they are set up for success via integration into well-designed and adequately funded health systems.
Six organizations – Hope Through Health, Last Mile Health, Living Goods, Muso, Partners In Health, and Possible – have developed high-impact CHW programs with governments and communities across the globe. Understanding that several operational questions are unresolved by current academic evidence, they have come together to create a report identifying insights from their implementation experience.