The World Health Organization recently released the first global guidelines for the design of Community Health Worker (CHW) programs. The guidelines suggest how governments like Nepal can design and implement high-impact CHW programs, on the path toward achieving universal health coverage (UHC).
The guidelines cover three categories, including 1) CHW selection, education, and training; 2) management and supervision; and 3) integration into and support by health systems and communities. Broadly, the guidelines recommend CHWs be locally-selected, trained both pre-service and continuously, formally certified, supervised, paid, provided opportunities for career growth, engaged in data reporting, and closely integrated with local healthcare facilities and communities.
CHWs are critical to the delivery of healthcare globally, and there is increasing recognition that CHW programs will provide a key path towards achieving the Sustainable Development Goals (SDG) and UHC. In parallel, global investments in CHW programs have increased dramatically in recent years to assist governments and health sectors to build further CHW capacity. Yet, despite this increased recognition and investment, implementation of CHW programs remains uneven– frequently, best-practice examples are not replicated or scaled, and evidence-based practices are not adopted by policymakers.
Nyaya Health Nepal and Nepal’s Family Health Division are currently piloting a new CHW program that is closely aligned with WHO recommendations, and early results suggest the program could provide catalytic progress towards the SDGs. Further results from our pilot are expected in 2019 – 2020, and we look forward to working further with Ministry of Health to build community health systems, aligned with global best practices, that will enable Nepal to realize its commitment to healthcare for all.