Table 1.

Criteria for successful CHW programmes (Hermann et al 2009)

Basic essential conditions	Description
Selection and motivation	CHW need to understand the community in which they work and be trusted Formal education less important than motivation to work in community
Initial training	Content and length should be based on existing knowledge and experience Should be participatory and focus on practical skills and problem-solving Communication and counselling should be emphasized
Simple guidelines and standardized protocols	Materials should ensure CHW cover all areas in which they have been trained Manuals prevent CHW feeling overwhelmed by multiple tasks Can be used as basis for supportive supervision
Supervision and support	Regular mentoring and refresher training maintain motivation Structured and constructive supervision maintains programme quality
Adequate remuneration/career structure	Remuneration in some form crucial for CHW to feel valued Compensation increases CHW commitment and reduces drop-out
Required for scale-up
Political support	Formal role of CHW needs to be defined over time and regulated within broader health system
Alignment with health system strengthening	Functioning health system required for CHW to function effectively CHW should make referrals to comprehensive constellation of services
Flexibility and dynamism	Programmes should evolve and adapt as social and health conditions change
Specific to ART support
Using experience of people living with HIV	CHW living with HIV offer hope and inspiration and can lead by example
Focus on chronic care, retention and adherence	Self-management and sustainability of care key issues to address by CHW CHW should emphasize skills for long-term retention in care and adherence