Dear Neil, I think that in your comment on 'ladder of career' for CHWs you forgot one essential thing: CHW are nowhere employed/salaried by their respective system of health. They are a product of NGOs working in Africa.
HIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He currently works on a volunteer basis in an excellent missionary/credited hospital in north Uganda, St. Mary's Hospital-Lacor-GULU. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health. massimoser20 AT gmail.com