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Costs and cost-effectiveness of integrated horizontal community health worker programmes in low- and middle-income countries (2015-2024): a scoping literature review

August 30, 2025 By

Authors: James O' Donovan, Meghan Bruce Kumar, Madeleine Ballard, Martina Mchenga, Lily Martin, Mardieh Dennis, Molly Mantus, Ariwame Jiménez, Trio Sirmareza, Jessica Cook, Patrick Kawooya, Zeus Aranda, Angele Bienvenue Ishimwe, Rizky Deco Praha, Karen E Finnegan, Katherine Ruffing, Maryse Kok, Matias Iberico, Daniel Palazuelos, Sophie Witter, Megha Rao, Ranu S Dhillon, Harriet G Napier, Marius Nkenfack, Linnea Stansert Katzen, Lazola Makhupula, Margaret Odera, Michee Nshimayesu, Kelsey Vaughan

This review looked at studies on the costs and value of community health worker (CHW) programs in low- and middle-income countries. It included 18 studies covering 42 cases. The review found that while CHWs are important for health care, most studies only reported basic costs, like salaries and program expenses, with limited evidence on whether programs were affordable or cost-effective. Salaries varied widely, and the average program cost was about $6 per person each year. Only a few studies showed CHW programs were clearly cost-effective. Overall, there is not enough strong economic evidence to guide governments on investing in CHWs, and more large-scale studies are needed.

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Resource Topic: CHW programs

Resource Type: Review

Year: 2025

Region: Global, Not specified

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Publisher May Restrict Access: No

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