CHWs (23) Selection, training and certification: a global North study

6 June, 2019

Hi All,

The Journal of Health Affairs had an interesting article on home and community-based health aides in the U.S. The article looks at income, selection, training, certification and supervision. One of the reasons the CHW Guideline is so relevant is that issues for community health workers transcend socio-economic status and national boundaries. What do you see as some of your country’s challenges in the areas of selection, training and certification? Please let us know where your work is concentrated and whether you have observed best practices.

Home health and personal care aides are one of the largest groups of health care workers in the US, with nearly three million people providing direct care for people with serious illness living in the community. These home care workers face challenges in recruitment, training, retention, and regulation, and there is a lack of data and research to support evidence-based policy change. Personal care aides receive little formal training, and they experience low pay and a lack of respect for the skill required for their jobs. High turnover and occupational injury rates are widely reported. There is little research on the factors associated with higher-quality home care, the extent to which worker training affects client outcomes, and how regulations affect access to and quality of home care. Health care leaders should seek to fill these gaps in knowledge, support the establishment of training standards and programs, implement Medicaid reimbursement strategies that incentivize improvements in pay and working conditions, reform regulations that now prevent the full utilization of home care workers, and create sustainable career pathways in home care policies.

Kind regards,


Catherine Kane

Community Health Worker Guideline Communications & Advocacy

Human Resources for Health Policies & Standards

Health Workforce Department

World Health Organization

Avenue Appia 20, CH-1211 Geneva 27

HIFA profile: Catherine Kane is a member of the WHO Health Workforce team, responsible for advocacy and dissemination of the Guideline on health policy and system support to optimize community health worker programmes. She has experience with community health worker programmes at strategic and operational levels through WHO, the International Federation of Red Cross and Red Crescent Societies and at one point as a social worker supporting migrant communities. Twitter: readycat