WHO Guidelines for Community Health Workers (October 2018)

Among the documents prepared for the Astana Conference on Primary Health Care (PHC) in October 2018 was a new  WHO 'guideline' on community health workers (CHWs). The document is noted in a recent update from the People's Health Movement (PHM).

"The Guideline, as summarised in A72/13 (paras 10 & 11), concludes that:

• 10. Evidence across and within countries indicates that support for community health workers and their integration into the health system and the communities they serve is uneven. Examples of good practices exist but are not necessarily replicated. Policy options for which there is greater evidence of effectiveness are known but not uniformly adopted. Accordingly, the performance of community health worker programmes is highly variable, hindering the full realization of their potential contribution to the implementation of primary health care policies.
• 11. Common shortcomings identified across a range of community health worker programmes include: poor planning; unclear roles, education and career pathways; lack of certification hindering credibility and transferability; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; inadequate coordination, supervision, quality control and support; and lack of recognition of the contribution of community health workers. These challenges can contribute to the inefficient utilization of human capital and financial resources. Many community health worker initiatives fail to be properly integrated into health systems and remain pilot projects or small-scale initiatives that are excessively reliant on donor funding; conversely, uneven management and support for community health workers in many contexts may result in substandard capacities and performance of the health workers concerned.
  

The summary of the Guideline in A72/13:

• lists 6 key principles which should be realised in CHW programs;
• lists 7 policy recommendations (selection, certification, supervision, compensation, entitlements, career development, service delivery models);
• lists key actions for the design and implementation of CHW program at the national level, and for international organisations (donors and IGOs)."

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