Strengthening the capacity of community health workers to deliver care for sexual, reproductive, maternal, newborn, child and adolescent health

Overview

Government institutions, United Nations agencies, and global partners have been repositioning the role that community health workers (CHWs) can play in increasing access to essential quality health services in the context of national primary health care and universal health coverage. Given the growing momentum and interest in training CHWs, the United Nations health agencies (H4+)have developed this technical brief to orient country programme managers and global partners as to key elements for strengthening the capacity of CHWs, including health system and programmatic considerations, core competencies, and evidence-informed interventions for CHWs along the SR/MNCAH continuum of care. These key elements need to be adapted and contextualized by countries to reflect the structure, gaps, and opportunities of the national primary health care system, the interaction between the health sector with other sectors, and the specific roles and competencies that CHWs already have within that system. These key elements should also guide H4+ members and partners to take a joint and harmonized approach to supporting countries in their capacity-development efforts. Annex 1 lists SR/MNCAH interventions that CHWs can perform based on the best available evidence and existing WHO guidance.

The term “community health worker” is often used to refer to very different typologies of volunteer or salaried, professional or lay health workers whose level of training, competencies, scope of practice and integration in health systems vary widely. This inadvertently creates difficulties in reviewing the evidence of their respective contributions to health outcomes. To inform evidence-based decision-making WHO’s Health Workforce Department intends to prepare new guidelines on the role, scope and contributions of Community-Based Practitioners, with due attention to the differing occupational classifications and typologies, including lay workers, community health workers, auxiliary/associate professionals, advanced practitioners and professionals - all of whom contribute to community care.