Good morning. Regarding the CHW career progression, In Iran where the CHWs (BEVARZ), are the part and parcel of the health system and are formally recruited by the Ministry of health& Medical education since 1973 and some of them already have been retired after 30 years of services, CHWs progression is as follow:
After at least 10 years of excellent services in HEALTH HOUSE, she or he will be promoted as Senior BEHVARZ at Health Houses. Her/His new role will be as assistant supervisor and instructor for the newly trained BEHVARZ in the Health House After some years services in this position and gaining experiences. She will be posted in the CHW Training Center as assistant Instructor, who will assist in teaching of new batches of CHW, mainly in practical sessions in class and supervision in the field and health houses in the village. After some years experiences as assistant instructor and proving herself and passing some tests and evaluation by the Instructors and manager of the CHWS Training Center she will be promoted to INSTRUCTOR of the CHW Training Center. Finally the best one could be assigned as the manager of the CHW Training Center after receiving some short term courses on management of the training center. Needless to say that we do not push them to go to the nursing or medical school. But if some of them take part and pass the National Entrance Exam for medical or Nursing school they, will be allowed to join and after graduation they will be recruited by the ministry of health with their new degree. But to my knowledge it was very rare.
In my points of view, as far as the training system of CHWs is completely different from the training system of Medical & Nursing school in terms of community based and problem solving approach, I would recommend that their promotion goes within their own system. Except until the educational system of medical & nursing school be reorient towards community oriented one.
Respectfully. Dr. Mohammad Ali Barzegar.
HIFA profile: Mohammad Ali Barzegar is an initiator of Primary Health Care in Iran since 1971, and Representative of People's Health Movement (PHM) Iran. His interest include 45 years of national & international experiences on PHC, Sustainable Development and Public Health. barzgar89 AT yahoo.com