Community-based health workers: Head start or false start towards health for all?
Health service delivery programs using minimally-trained community-based health workers (CHWs) have been established in many developing countries in recent years. These programs are expected to improve the cost-effectiveness of health care systems by reaching large numbers of previously underserved people with high-impact basic services at low cost. The reported experience with these programs has been mixed, raising questions about whether the community health worker is an optimal vehicle for extending primary health care. This review of six large-scale community-based worker programs suggests that they have succeeded in some of their objectives but not in others. CHWs increase the coverage and equity of service delivery at low cost compared with alternative modes of service organization. However, they do not consistently provide services likely to have substantial health impact and the quality of services they provide is sometimes poor. Large-scale CHW systems require substantial increases in support for training, management, supervision, and logistics. The evidence suggests that, in general, their potential has not been achieved in large routine programs. Further development of these programs is needed to reinforce their successes and assure that they are adequately supported as an integral component of the basic health system.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 25 (1987)
Issue (Month): 5 (January)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:25:y:1987:i:5:p:443-459. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If references are entirely missing, you can add them using this form.