Skip to main content

Table 2 Common roles of CHWs in national programmes (with examples)

From: Community health workers at the dawn of a new era: 1. Introduction: tensions confronting large-scale CHW programmes

Role Examples
Health educator, health promoter, behaviour change agent:  
 Individual level Family planning; maternal, infant, and child health, and nutrition
 Community level Community-led total sanitation and other water and sanitation initiatives; facilitating women’s groups
Adherence-support counsellor For those taking medications for treatment of TB and/or HIV
Link community members to health services As “navigator” or “accompagnateur”; including screening/case-finding and referral (e.g., for malnutrition) and default tracing (e.g., for HIV and TB patients)
“Depot-holder”, dispenser of health commodities Oral contraceptive pills, oral rehydration salts, and zinc for child diarrhoea
Campaign field worker Polio national or subnational immunization days or other supplemental immunization activities, child health days, mass distribution events for insecticide-treated nets or ivermectin (e.g., using a community-directed interventions approach)
Vaccinator Routine child immunization and tetanus immunization as a component of antenatal care
Disease surveillance, case finding, reporting, and referral Malaria, acute flaccid paralysis/polio, epidemic diseases (Ebola, Zika, COVID-19)
Limited clinical functions (otherwise performed by physicians or nurses), under task-shifting arrangements Management of childhood illness, family planning, clinical procedures (e.g., injectable contraceptives, inserting contraceptive implants), diagnostics (using rapid diagnostic kits), childbirth care (antenatal care, formerly traditional birth attendant programmes, more recently community midwife or “skilled birth attendant” services)
Assisting health professionals, either during outreach activities or at fixed health facilities Mobilization and site-level logistical support for routine immunization outreach
Enumerator, recording data Registration of pregnancies, births, and deaths; assisting with civil registration; surveillance reporting for notifiable communicable diseases (including outbreaks)