CHWs (17) What are your thoughts on the Guideline? (9) Role of CHWs in disability and rehabilitation (3)

4 June, 2019

Dear Sunanda,

You note that CHWs' role in community-based rehabilitation has been endorsed by WHO 'as the optimal strategy to reach out to a tenth of the world population'. Indeed CBR is prominently recognised and promoted by WHO:

A systematic review by the Campbell Collaboration (2015) concluded there is 'Moderate to high quality evidence shows that community-based rehabilitation has a positive impact on people with disabilities'.

Page 25 of the full WHO Guideline on CHWs contains a graphic of 'Primary health care services for which there is some evidence of CHW effectiveness', but this does not include disability or rehabilitation.

However, page 24 of the Guideline notes: 'This guideline did not appraise critically the body of evidence on which specific health services CHWs can deliver to quality standards, and thus it contains no recommendations regarding these aspects. Published evidence and existing WHO guidelines encourage the delegation of certain tasks relating to prevention, diagnosis, treatment and care, for example for HIV, tuberculosis (TB), malaria, other communicable and noncommunicable diseases, a range of reproductive, maternal, newborn and child health services, hygiene and sanitation, ensuring clients’ adherence to treatment, *rehabilitation and services for people affected by disabilities* [my emphasis], and advocating and facilitating underserved groups’ access to services.'

Best wishes, Neil

Coordinator, HIFA Project on Community Health Workers

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: