Evidence

Strengthening the large scale Community Health Worker (CHW) Program is essential for addressing the unmet healthcare needs in areas where public health services are neither plentiful nor comprehensive. Both the World Health Organization (WHO) and the World Health Assembly (WHA) have emphasized the need for strong CHW programs. This case study traces the history, origin, challenges, and the impact of one national CHW scheme - the Village Health Guides (VHGs) - to cull out lessons. The main causes of the failure of VHGs are the lack of support from the formal health sector and poor communication between government and health centers about the role of the VHGs. This study aims to apply the lessons learned from the VHG scheme to current CHW programs. This case study summarises that it is essential to engage health system actors at multiple levels, involve the community, integrate CHW programs with the health system, and garner political and financial support to ensure sustainability and long-term effectiveness. This paper can be helpful for both program implementers and policymakers in improving CHW program outcomes. 

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