Strengthening Primary Health Care through Community Health Workers: 

First, investment in CHWs is a requirement to achieving critical health objectives, including UHC, prevention and containment of health crises, meeting the core capacities of the IHR, progress towards disease elimination, keeping healthcare affordable and readily accessible, saving lives of mothers and children, and controlling priority diseases such as HIV, tuberculosis and malaria.

Second, investing in CHWs results in a positive return—as high as 10:1 when accounting for increased productivity from a healthier population, the avoidance of the high costs of health crises, and the economic impact of increased employment. 


Third, scale up of CHWs can lead to cost savings (short- as well as long-term cost savings) in other parts of the health system. Short-term savings could be used to support scale-up costs.

Fourth, investment in CHW systems yields further societal benefits, including empowering women, reducing patient costs, enabling data collection on civil registration and vital statistics, and enabling additional service delivery.


Guiding principles for scale-up and RETURN ON INVESTMENT (ROI)

When building CHW programs, maintaining ten core principles and a focus on performance management will ensure return on investment (ROI):  

  • Ensure national and local leadership in planning, executing, and monitoring
  • Include CHWs as part of frontline PHC teams
  • Engage communities in all aspects of CHW programs
  • Design and provide high-impact training for CHWs
  • Ensure supportive supervision and mentorship for CHWs
  • Develop high-quality integrated management for CHWs
  • Ensure CHWs are provided with adequate resources, tools, and supplies
  • Effectively incentivize and remunerate CHWs
  • Develop a sustainable financing solution for CHW programs
  • Monitor and evaluate CHW programs on an  ongoing basis