CHWs (37) Selection of CHWs for pre-service training (4)

9 June, 2019

The recommendation that CHWs have a "minimum educational level that is appropriate to the task(s) under consideration" is connected to so many other aspects of CHWs' success.

As the guideline rightly points out, "While a higher level of prior education may be associated with improved knowledge and performance, attrition (due to better and more diverse work opportunities) might be higher among more educated CHWs" (pg 34). There is a level of intimacy and trust required for CHWs to be effective, especially as they often work out of people's homes. Of course competency is important, but trust and education level are not necessarily correlated.

However, how much education is required to complete the "task(s) under consideration"? It varies, but is usually centered around finishing some basic education, such as primary or secondary.

I have noticed in the research that CHWs work well with a defined set of services that they master. There seems to be a tipping point at which CHWs are too overloaded with health conditions to check on, and they become less able to reach people with the same frequency or efficiency. Are there any specific studies that have been done looking at this relationship? Or has anyone had experience with this at the national or sub-national level? And what happens when CHWs are recruited for certain tasks and then other responsibilities are added on? How has that changed the performance of CHWs in those instances, or the planning for selection/training in the future?



HIFA profile: Amelia Plant is the Portfolio & Impact Manager at Preston-Werner Ventures, a San Francisco-based foundation looking to create scalable impact at the intersection of climate change and social justice. Amelia specializes in sexual reproductive health and rights, focusing on family planning information & access. She is currently based in Cairo, Egypt. She is a member of the HIFA working group on Family Planning and the HIFA wg on Community Health Workers.

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