Community Health Workers in National Programmes

Community health worker schemes expanded in many developing countries during the 1970s, aimed at promoting primary health care. In recent years questions have been raised about these programmes and the extent to which community health workers have become "just another pair of hands". This book presents the results of a large investigation into what has happened to CHWs in their many guises, in various national programmes. It looks at the context of changing health policies over the last four decades, the emphasis given to primary health care in the 1970s and the resulting confusion about the role of the community health workers. The second part of the book addresses issues about what tasks and skills they have, their place in the health system and the costs of the CHW programmes. Programmes in Botswana, Colombia and Sir Lanka are studied. Finally, the book looks beyond the problems currently being faced to see how such programmes can be made to work more successfully.