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