Authors: Andrea N. Kaschko
The question of remuneration for community health workers (CHWs) in low–‐income countries remains contentious. Programs use a variety of monetary and non–‐monetary incentives to motivate CHWs. The most successful programs, however, pay their workers, and there is little evidence to suggest that volunteerism in low–‐income countries is sustainable over the long term. Adequate compensation improves health worker motivation, retention and performance. Additionally, fair and consistent wages ensure a stable income and livelihood for CHWs. Although paying workers requires a modest investment of resources, cost should not be a significant barrier if governments and donors prioritize primary care. The World Health Organization (WHO) has consistently recommended that CHWs receive adequate wages in addition to other incentives. At the same time, they suggest that more research is needed to assess the effectiveness of paid versus voluntary workers. This paper reviews the literature to date in order to advise the WHO on how to provide stronger guidance on remuneration for CHWs. Specifically, the WHO should recommend that CHWs receive fair and consistent wages commensurate with workload and national standards, and governments should be responsible for regulating wages to ensure uniform payment across programs. Finally, the WHO should advocate for research that will inform best practice by addressing remaining gaps in the literature.
Resource Topic: Community Health Workers/Volunteers, Employee Engagement, Human Resources Management/Workforce Development, Monitoring and Evaluation, Motivation/incentives, Performance management, Performance-based incentives, Program Management, Recognition/remuneration, Recruitment and Retention, Training
Resource Type: Issue papers