The World Health Organization (WHO) offers another widely accepted definition of CHWs: Community health

workers should be members of the communities where they work, should be selected by the communities, should be answerable to the communities for their activities, should be supported by the health system but not necessarily a part of its organization, and have shorter training than professional workers’ [24]. It is widely recognized that basic functions of CHWs include delivery of culturally appropriate health education, assistance with accessing health services, provision of direct services (such as medication administration or observation

of medication ingestion), and peer support [13,24,25]. The range of services provided by CHWs therefore varies and is personalized INCB024360 concentration see more based on individual needs and socio-environmental determinants. The patient may require weekly home visits, education about his or her disease, assistance with obtaining benefits, reminders to take medications, accompaniment to medical appointments, and/or medication administration. Several studies have found that CHWs are effective at delivering directly observed therapy (DOT), which involves daily visits to provide medication or observe ingestion of medicine [26–30]. The idea of formally using community members to provide basic health services has existed internationally for at Thiamet G least 50 years. The Chinese barefoot doctors of the 1960s and 1970s and the Thailand Village Health Volunteers (an initiative that was officially implemented nationwide in 1977) are well-known examples of early programmes

[24]. Over the last several decades, training lay persons to address health issues such as respiratory illnesses, maternal and child health and malaria has become a more common community health practice in some areas of the world [28]. In addition, in developing nations, CHWs are often employed to reduce morbidity and mortality from infectious illnesses; successful programmes include the work of Socios en Salud in Peru and Partners in Health in Peru and Haiti [27,31,32]. Partners in Health has been particularly effective at assessing the results of their interventions in order to advocate for the use of CHWs. For example, since 1990, Partners in Health has shown that the ‘accompagnateur’ (CHW) model reduced mortality from tuberculosis [13] in rural Haiti. As HIV prevalence increased, coinfection with tuberculosis and HIV also became more common in Haiti. Zanmi Lasante responded by expanding their CHW programmes to increase access to HIV education, testing and home-based care provided by an accompagnateur [13].