Community Health Workers

When adequately skilled, supplied, supervised, and salaried, professional community health workers (CHWs) can close the distance to care in rural and remote communities—and drive progress toward universal health coverage.

Worldwide, two billion people lack access to primary healthcare—a crisis that is especially acute in poor, rural, and remote communities. For many families, reaching the nearest health center requires a journey of hours or days across difficult terrain by foot, and may include river crossings with fees they can’t afford.

Paid, professionalized community health workers offer a powerful solution to this urgent problem. Trained in an essential package of primary care skills, they deliver preventive, curative, and referral services to their neighbors. They provide routine visits such as pre- and post-natal checkups, screen for and treat diseases like malnutrition and malaria, and connect patients to health facilities for childbirth and serious illnesses. Alongside closing the distance to care, they play a critical role in preventing, identifying, and responding to emerging disease threats including epidemics and pandemics.

Woman holding toddler in lap.

Our Approach

Studies have shown that professional community health workers reduce child mortatily, improve maternal health outcomes, and provide essential surveillance and response during disease outbreaks. They are also highly cost-effective, with up to a 10:1 return on investment.

Scaling this proven, lifesaving intervention starts with investing in community health workers as a professional workforce. In order to achieve their full potential, community health workers must be skilled, salaried, supervised, and supplied by a well-functioning community health system operating at national scale and integrated into broader public systems via data and financing. We call these the Six Ss.

Woman riding on the back of a motercycle looking back.
Child having arm measured.

Community health workers have been integral to primary healthcare for decades, but paid, professionalized community health workers remain the exception, not the rule: in Africa, for example, only 14% are salaried. We believe all community health workers must be paid equitably and on time—and equipped with the supplies, training, supervision, and systems they need to perform at their best.

Last Mile Health partners with ministries of health to address government-identified priorities in realizing these conditions, working to establish and sustain strong, resilient community health systems that serve as global exemplars. Paid, professionalized community health workers are the core of these systems, bringing care to hard-to-reach communities.

In addition to supporting partner governments in ensuring community health workers are supported with all Six Ss, we advocate for the global adoption of these standards, and have contributed to the World Health Organization’s first-ever community health worker guidelines.

Resources

  • The Six Ss

    In order to succeed, community health workers must be part of health systems with these key components.

  • The Monrovia Call to Action

    A joint call to action urging governments to invest in community health programs as an integral path to universal health  coverage, including advocating for fair pay for community health workers.

Read More on Last Mile Health’s Blog

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Last Mile Health launches Ethiopia’s first non-communicable disease training for community health workers

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Blog Post

Highlights from Skoll World Forum 2024

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Blog Post

“Change starts from the ground”: A profile of community health worker John Wabwire

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Blog Post

“They have the power to save themselves”: Profiling three community health workers from Malawi

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