Articles

Community health workers and accountability: reflections from an international “think-in”

Schaaf, Marta L.; Fox, Jonathan; Topp, Stephanie M.; Warthin, Caitlin; Freedman, Lynn P.; Robinson, Rachel S.; Thiagarajan, Sundararaman; Scott, Kerry; Maboe, Thoko; Zanchetta, Margareth; Ruano, Ana L.; Kok, Maryse; Closser, Svea

Community health workers (CHWs) are frequently put forward as a remedy for lack of health system capacity, including challenges associated with health service coverage and with low community engagement in the health system, and expected to enhance or embody health system accountability. During a ‘think in’, held in June of 2017, a diverse group of practitioners and researchers discussed the topic of CHWs and their possible roles in a larger “accountability ecosystem.” This jointly authored commentary resulted from our deliberations. While CHWs are often conceptualized as cogs in a mechanistic health delivery system, at the end of the day, CHWs are people embedded in families, communities, and the health system. CHWs’ social position and professional role influence how they are treated and trusted by the health sector and by community members, as well as when, where, and how they can exercise agency and promote accountability. To that end, we put forward several propositions for further conceptual development and research related to the question of CHWs and accountability.

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Also Published In

Title
International Journal for Equity in Health
DOI
https://doi.org/10.1186/s12939-018-0781-5

More About This Work

Academic Units
Population and Family Health
Published Here
August 20, 2018

Notes

Global health, Community health workers, Accountability, Equity, Power relations, Universal health coverage