Towards universal health coverage: What are the system requirements for effective large-scale community health worker programmes?
Abstract
Against the background of efforts to strengthen health
systems for universal health coverage and health equity,
many African countries have been relying on lay members
of the community, often referred to as community health
workers (CHWs), to deliver primary healthcare services.
Growing demand and great variability in definitions, roles,
governance and funding of CHWs have prompted the
need to revisit CHW programmes and provide guidance on
the implementation of successful programmes at scale.
Drawing on the synthesised evidence from two extensive
literature reviews, this article determines foundational
elements of functioning CHW programmes, focusing in
particular on the systems requirements of large-scale
programmes. It makes recommendations for the effective
development of large-scale CHW programmes.
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