Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations

Authors: Dr. Bernice Dahn, Dr. Addis Tamire Woldemariam, Dr. Henry Perry, Dr. Akiko Maeda, Drew von Glahn, Dr. Raj Panjabi, Na’im Merchant, Katy Vosburg, Dr. Daniel Palazuelos, Dr. Chunling Lu, John Simon, Jerome Pfaffmann, Daniel Brown, Austin Hearst

Despite the progress some countries have made in scaling up CHW programs, many countries that would benefit from strong CHW cadres currently have only ad hoc, sub-scale programs. This problem extends even to high-income countries that would benefit from CHW programs to provide cost-effective care and battle chronic disease. Countries wishing to scale these programs using a coordinated national strategy face many challenges. Chief among these challenges are limited political prioritization of CHWs and a subsequent lack of financing: insufficient and inaccessible international funding as well as limited alignment on pathways for domestic financing.

These challenges were taken up by a high-level panel convened by Prime Minister Hailemariam Dessalegn of Ethiopia and Ray Chambers, the United Nations Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria. This report states the three key takeaways from this panel’s investigation of CHW financing and offers seven recommendations to support countries in the development of strong, integrated CHW programs.