The Community Health Systems Reform Cycle: Strengthening the Integration of Community Health Worker Programs Through an Institutional Reform Perspective

Authors: Nan Chen, Mallika Raghavan, Joshua Albert, Abigail McDaniel, Lilian Otiso, Richard Kintu, Melissa West, and David Jacobstein

Because community health workers (CHWs) are key to achieving health equity, governments and CHW program managers are interested in effective ways to scale up CHW programs. Experts developed a framework based off of CHW program scale-up efforts across 7 countries and found that successful scaling of CHW programs was dependent on iterative learning and public health solutions that were reasonable for the resources and capacity available in a specific context. This framework, Community Health Systems Reform Cycle, can serve as a guide to governments, NGOs, and other stakeholders of CHW programs to drive successful scale-up of CHW programs.