CHWs (21) What are your thoughts on the Guideline? (12) The career lifecycle of a CHW

5 June, 2019


Thanks for starting this useful discussion on the WHO's CHW Guideline and recommendations.

When I first read through it, I began mapping out each of the recommendations to the career lifecycle of a CHW. This later turned into the attached infographic [*see note below] that can be useful to map out at what stage of a CHW's career the WHO recommendations would take place.

Some more thoughts about the Guideline and recommendations can be found here:

In particular, as we look at CHW programs and where they fit within health systems and existing health worker teams, these recommendations really need to be contextualized into national and local health systems. I have heard some people debate which recommendations should be implemented versus deprioritized; what I think is more useful is to consider which combination of recommendations would have the greatest impact. For example, it is not useful to contract and pay a CHW but then not provide supportive supervision or support his/her enabling environment or hold him/her accountable for a reasonable scope of work. Likewise, the new CHW programs are an opportunity to transform pre-service education - many CHWs in LMIC settings have been trained through a patchwork of donor-supported trainings and it is hard to know what their qualifications are / the quality of the training, and what performance support is needed to ensure they provide quality health prevention, promotion, curative, palliative, and/or referral services.

In addition, I think that we have a lot more to learn about opportunities within the community health labor market. How can we promote career development of young CHWs who are committed to their communities' health but want to continue their education and advance within the health sector? What are viable CHW career paths? While CHW professionalization and recognition is essential for SDGs and promoting decent work, there may inevitably be community health volunteers who continue to provide support in their communities on an ad-hoc, part-time basis. What do we, as a global health community, do to harness and appropriately recognize their roles as well?

I look forward to continuing the conversation!



Rachel Deussom

Technical Director

HRH2030: Human Resources for Health in 2030


Skype: rachel.deussom

241 18th Street South, Ste 1200, Arlington, VA 22202

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HIFA profile: Rachel Deussom is a Health Workforce Officer, CapacityPlus with IntraHealth International, USA. Her professional interests are human resources for health (HRH), mHealth, M&E, MNCH, health information systems and midwives. rdeussom AT

[*Note from HIFA moderator (Neil PW): HIFA does not carry attachements but the infographic can be seen as part of the blog in the above URL]