World Vision International
World Vision commends the Executive Board for this report, in particular references to CHW programs and the guidelines on health policy and system support to optimise CHW programs, as well as the report CHWs delivering primary health care: opportunities and challenges. We endorse all the recommendations made in both reports.
CHW effectiveness is well-documented, as is the variability of CHW program design, support and functionality. With the availability of multiple systematic reviews and guidance documentation there is no rationale for sub-optimally designed and managed programs - yet they persist. This status is attributable to government, donors, third-party implementers alike.
We call on Member States to take responsibility for leadership, harmonisation and coordination of CHW programs within your countries.
Furthermore, universal functionality requirements of CHW programs have been documented. Comprehensive address of these requirements, i.e. supportive supervision and professional incentive, is the minimum standard for this health worker cadre, and must be adequately represented in policy, resource allocation, implementation and monitoring. Failure to address well-established functionality requirements is unethical. We call on all States with CHW programs to review available functionality standards and ensure they are comprehensively implemented.
CHWs provide the best community-level public health interface with families, with capacity to address the nexus of individual behavior and health determinants. They significantly expand the reach and scope of health services, strategically towards most vulnerable populations; they are on the frontlines of 2030 agenda implementation. CHWs care for their communities, and we must care for them. We call on Member States to recognise CHWs in the measurement of and reporting on human resources for health and to scale up CHW platforms, appropriate to context, and to ensure their quality and effectiveness.