community health worker

The World Health Organization defines community health workers as health care providers who live in the community they serve and who receive lower levels of formal education and training than professional health workers such as doctors, nurses and midwives. The distinction is not simply about where someone works. WHO's 2018 guideline says programmes should select community health workers on educational level, membership of and acceptance by the community, personal attributes and gender equity, which makes community membership a selection criterion rather than an accident of geography.

What they actually do is set by the programme that trains them. WHO's guideline lists evidence of effectiveness across home based care for newborns, encouraging women to seek care during pregnancy, immunisation uptake, the management of childhood malaria, pneumonia and diarrhoea, contraception and family planning, tuberculosis and HIV care, control of neglected tropical diseases, and behaviour change work on diabetes, hypertension and asthma. The guideline groups these as preventive, promotional and curative services. Its argument for them is reach: they get to people that clinics and hospitals do not.

Calling them workers rather than volunteers is deliberate. WHO recommends written contracts setting out roles and rights, supportive supervision, pay commensurate with the demands of the job, and a career ladder toward other health qualifications, because many programmes have relied on unpaid volunteers with none of those. The guideline takes its scope from the International Labour Organization's International Standard Classification of Occupations, which is what gives the category a formal shape rather than leaving it a loose description.