Table 1 Compensation and incentives provided to CHWs in national programmes
From: Community health workers at the dawn of a new era: 8. Incentives and remuneration
Country | CHW cadre | Formal employee vs volunteer | Full-time vs part-time | Salary | Other types of support and incentives | Additional compensation |
|---|---|---|---|---|---|---|
Afghanistan | Community Health Worker (CHW) | Volunteer | Part-time | Unpaid | Allowances to cover travel and food for all monthly meetings at the facility and any training courses they attend The TB programme offers two prizes of US$ 100 per province per quarter to the best-performing health workers | Many communities have built a house or an extension to the CHW’s house for the health post, assist with transport, promote health campaigns, and support the CHWs in their work with individual families |
Bangladesh | Shasthya Shebika (BRAC) | Volunteer | Part-time | Unpaid | NA | Small loans to establish revolving funds, which they use to make some money by selling health products at a small mark-up Monthly performance-based incentives |
Shasthya Kormi (BRAC) | Formal employee | Part-time | $190 per month | NA | NA | |
Family welfare assistant (FWA) (government) | Formal employee | Full-time | $132–$318 per month | NA | NA | |
Health assistant (HA) (government) | Formal employee | Full-time | $132–$327 per month | NA | NA | |
Community healthcare provider (CHCP) (government) | Formal employee | Full-time | $150–$362 per month | NA | NA | |
Brazil | Agente Comunitário de Saúde (ACS) | Formal employee | Full-time | $281–$472 per month | NA | NA |
Ethiopia | Health extension worker (HEW) | Formal employee | Full-time | $86 per month | Opportunities for career advancement | NA |
Women’s Development Army (WDA) | Volunteer | Part-time | Unpaid | Formal recognition from the health system Ongoing mentorship by HEWs Certificates Recognition by the community and local leaders | NA | |
Ghana | Community-based Health and Planning Services (CHPS) community health officer (CHO) | Formal employee | Full-time | $140 per month | NA | Extra paid leave days The opportunity to advance their education with paid education leave |
CHPS community health volunteer (CHV) | Volunteer | Part-time | Unpaid | T-shirt, transport per diem, and bicycle | NA | |
Guatemala | Promotor de salud* | NA | NA | NA | NA | NA |
Guardian de Salud* | Formal employee | Full-time | $50 per month | Community recognition and family support | NA | |
India | Auxiliary nurse-midwife (ANM) | Formal employee | Full-time | $280 per month | NA | NA |
Anganwadi worker (AWW) | Volunteer | Full-time | $50–$130 per month | NA | NA | |
Accredited social health activist (ASHA) | Volunteer | Part-time | $42–$56 per month | NA | NA | |
Village health guide (VHG)* | Volunteer | Part-time | $24 per month | NA | NA | |
Indonesia | Kader | Volunteer | Part-time | Unpaid | May receive informal types of compensation, such as free medical treatment from higher levels in the health system | NA |
Iran | Behvarz (rural) | Formal employee | Full-time | $350 per month | NA | Adjustments are made based on a combination of catchment area size and performance |
Moraghebe-Salamat (urban) | Formal employees | Full-time | $350 per month | NA | Adjustments are made based on a combination of catchment area size and performance | |
Kenya | Community health volunteer (CHV) | Volunteer | Part-time | $20–$60 per month | NA | NA |
Liberia | National community health assistant (CHA) | Formal employee | Part-time | $70 per month | Training certificate, formal role in the public health system, commodities, and medical supplies | NA |
Community health service supervisor (CHSS) | Formal employee | Full-time | $313 per month | NA | Gasoline allotment | |
Madagascar | Agent Communautaire (AC) | Volunteer | Part-time | Unpaid | Travel, equipment and materials, food, community recognition and support, promotion to a supervisory position | Per diems for trainings and meetings when there is a training or campaign Indemnities Income from user fees Access to savings and lending groups and insurance groups Support for income-generating activities |
Agent Communautaire de Nutrition (ACN) | Volunteer | Part-time | Unpaid | Training, travel opportunities, equipment and materials, food, community recognition and support, promotion to a supervisory position | $17 per month when there is an active project Per diems for trainings and meetings when there is a training or campaign Indemnities Income from user fees Access to savings and lending groups and insurance groups Support for income-generating activities | |
Malawi | CHW | Formal employees | Full-time | $63 per month | Uniform, T-shirt, bag, public recognition and a bicycle | Per diems |
Mozambique | Agentes Polivalente Elementare (APE) | Volunteer | Part-time | $20 per month | Bicycle, flashlight, vest, medicine bag, identification badge, hat, calculator, thermometer, and stopwatch (to measure respiratory rate) | NA |
Myanmar | Auxiliary midwife (AMW) | NA | NA | NA | Service packages, refresher training, continuous supplies, regular supportive supervision, as well as recognition and career advancement opportunities | NA |
CHW | NA | NA | NA | NA | NA | |
Malaria volunteer | Volunteers | NA | Quarterly incentive, amount unknown | NA | NA | |
TB volunteer | Volunteers | NA | A set amount per TB case referred | NA | NA | |
Traditional birth attendant | NA | NA | NA | NA | NA | |
Nepal | Female community health volunteer (FCHV) | Volunteer | Part-time | Unpaid | Refresher trainings, a uniform, a bag and a start-up kit of supplies | Training allowances, an annual clothing allowance, access to microcredit funds |
Niger | Agent de Santé Communautaire (ASC) | Formal employee | Full-time | $100 per month | NA | NA |
Relais volunteer | Volunteer | Part-time | Unpaid | Gifts of produce from crops | $20 per month, but this is irregular and infrequent Occasional payments for trainings or participation in mass campaigns | |
Nigeria | Community health extension worker (CHEW) | Formal employee | Full-time | $281 per month | NA | NA |
Voluntary village health worker (VVHW) and community-directed distributor (CDD) | Volunteer | Part-time | Unpaid | NA | NA | |
Pakistan | Lady health worker (LHW) | Formal employee | Full-time | $85 per month | NA | NA |
Rwanda | Binôme | Volunteer | Part-time | Unpaid | NA | Performance-based financing incentives One is for achievement of specified targets for the CHW cooperative (and the cooperative receive the incentive) Another is for individual event-based performance |
Agent de Sante Maternelle (ASM) | Volunteer | Part-time | Unpaid | NA | ||
Sierra Leone | National CHW | Volunteer | Part-time | CHW: $14 per month Peer supervisor: $20 per month | T-shirt, backpack, and supplies | CHWs: Those CHWs serving communities within 3 km of a health facility receive an additional $7 per month Those CHWs serving communities 3 km or further from a health facility receive an additional $11 per month Peer supervisors: Receive an additional $14 for transportation and logistics |
South Africa | Ward-based primary healthcare outreach team (WBPHCOT) | Volunteer | Part-time | $150–$290 per month | NA | NA |
Tanzania | CHW | Formal employee | Full-time | $143 per month | Community recognition | NA |
Thailand | Village health volunteer (VHV) | Volunteer | Part-time | $20 per month | Sponsored leisure activities, parties, and field trips | Possible national awards |
Zambia | Community health assistants (CHA) | Formal employee | Full-time | $390 per month | A bicycle, all-weather boots, a backpack, and a uniform | NA |
Zimbabwe | Community-based volunteer (CBV) | Volunteers | Part-time | Unpaid | NA | NA |