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The role of community health workers in primary care

Guest Editors:
Indiran Govender: Professor, Sefako Makgatho Health Sciences University, Gauteng Province, South Africa
Lisa R Hirschhorn, MD MPH: Professor Medical Social Sciences, Director Ryan Family Center for Global Primary Care, Feinberg School of Medicine, Northwestern University, United States
Joseph Mumba Zulu: Associate Professor of Community Health, University of Zambia, School of Public Health, Zambia


BMC Primary Care has published this Collection on The role of community health workers in primary care. Community health workers (CHWs) are health care professionals who provide health care services at the community level, directly engaging with the community to promote optimal health and well-being, provide basic health care services, and collaborate with health care organizations and policymakers to advise on community-level challenges. By engaging with communities, CHWs promote healthcare services that are responsive to the unique needs of different social and economic groups, age ranges, and geographical regions.

Meet the Guest Editors

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Indiran Govender: Sefako Makgatho Health Sciences University, Gauteng Province, South Africa

Dr Govender is a family physician working in the primary health care field. He has published 112 research papers in peer reviewed journals. He is the head of department of family medicine and primary care at Sefako Makgatho Health Sciences University and Dr George Mukhari Academic Hospital. He has three lovely children and enjoys the outdoors with a hiking trip every week. 
 

Lisa R Hirschhorn, MD MPH: Feinberg School of Medicine, Northwestern University, United States

Lisa Hirschhorn is Professor of Medical Social Science and Director for the Ryan Family Center for Global Primary Care at Northwestern University Feinberg School of Medicine and Director for Implementation and Improvement Science at Last Mile Health. Trained in medicine and HIV, Dr Hirschhorn is an expert in implementation research and patient-centered outcome research, actively applying these methods to improve the quality and equity of care in resource-limited settings including primary care, non-communicable diseases, maternal and child health, HIV and for older people. She also supports CHW delivery and quality in Liberia and Togo and works to increase the integration of CHWs into global efforts to strengthen primary care equity and effectiveness.
 

Joseph Mumba Zulu: School of Public Health, University of Zambia, Zambia

Joseph Mumba Zulu is an Associate Professor of Community Health in the School of Public Health, University of Zambia (UNZA). He formerly worked as Director for the Institute of Distance Education at UNZA and Assistant Dean, Research, School of Public Health. He is specialized in community-based implementation research. He has more than 15 years of professional and research experience in community-based health workers, research ethics, sexual reproductive health and rights, health policy and systems research, gender, and infectious diseases. He was a Guest Editor for the special issue on “Community Health Workers at the Dawn of a New Era.” 

About the collection

BMC Primary Care has published this Collection on The role of community health workers in primary care.

Community health workers (CHWs) are health care professionals who provide health care services at the community level, directly engaging with the community to promote optimal health and well-being, provide basic health care services, and collaborate with health care organizations and policymakers to advise on community-level challenges. By engaging with communities, CHWs promote healthcare services that are responsive to the unique needs of different social and economic groups, age ranges, and geographical regions.

Although CHWs typically receive a lower level of education than traditional primary care providers (such as doctors, nurses, and pharmacists), this community-led approach is essential for improving patient outcomes and reducing healthcare inequalities, particularly in vulnerable, underrepresented, and economically disadvantaged communities where there may be significant social, economic, and geographical barriers to healthcare provision.

As such, the increased presence of trained, salaried, and supervised CHWs who are integrated into health systems, and increased CHW outreach and service provision shows promise as an effective strategy for improving primary care delivery in communities that face substantial access challenges. Recent global health crises, including Ebola and COVID-19, have highlighted the critical role of CHWs in responding to pandemics and other major health crises.

Despite the growing recognition of the importance of a community health worker-led approach, more research is needed to explore the effectiveness of CHWs for improving patient outcomes and experiences in different settings, populations, and for different health conditions in primary care. This research may help guide policymakers in the development of improved service delivery models tailored to community needs.

This Collection welcomed high-quality submissions that contribute to our understanding of the importance of CHWs in primary care, including research related to:

  • Using CHWs to address stigma, barriers, and low patient engagement with primary healthcare services in different populations
  • Using CHWs to address specific health conditions or regions
  • The role of CHWs in preventing, identifying, and treating mental health problems
  • The role of CHWs in preventing, identifying, and managing infectious diseases such as HIV/AIDS and COVID-19
  • The collaboration between CHWs and other health care services
  • Patient and healthcare provider perspectives on CHW programs
  • The knowledge, attitudes, and training of CHWs, including approaches for measuring quality of care delivery
  • Health care policy and implementation research aimed at developing effective strategies for implementing community health care programs, including the cost-benefits of community health care programs
  • Studies reporting the scalability and sustainability of CHW programs, and studies reporting the challenges and successes of a CHW-led approach
  • All research related to the above that highlights challenges and developments in low- or middle-income countries (LMICs) or where these lessons have informed CHW programs in high-income countries (HICs)

In publishing this Collection, BMC Primary Care particularly welcomed research that supports the United Nations’ Sustainable Development Goals (SDGs), including but not limited to SDG1 (No Poverty), SDG3 (Good Health and Wellbeing), SDG5 (Gender Equality), and SDG10 (Reduced Inequalities).


Image credit: AndreyPopov / Getty Images / iStock

  1. Community Health Workers (CHWs) play a crucial role in outbreak response, including health education, contact tracing, and referral of cases if adequately trained. A pilot project recently trained 766 CHWs in ...

    Authors: David Musoke, Grace Biyinzika Lubega, Belinda Twesigye, Betty Nakachwa, Michael Obeng Brown and Linda Gibson
    Citation: BMC Primary Care 2024 25:260
  2. The purpose of this study was to quantify how much of the burden of visual impairment (VI) and unmet need in Talagang, identified by Rapid Assessment of Avoidable Blindness (RAAB) survey data, has been address...

    Authors: Muhammad Zahid Jadoon, Zahid Awan, Muhammad Moin, Rizwan Younas, Sergio Latorre-Arteaga, Elanor Watts, Marzieh Katibeh and Andrew Bastawrous
    Citation: BMC Primary Care 2024 25:250
  3. Noncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related...

    Authors: Ikechukwu A. Orji, Abigail S. Baldridge, Mercy U. Ikechukwu-Orji, Bolanle Banigbe, Nelson C. Eze, Aashima Chopra, Kasarachi Omitiran, Guhan Iyer, Deborah Odoh, Morenike Alex-Okoh, Rifkatu Reng, Lisa R. Hirschhorn, Mark D. Huffman and Dike B. Ojji
    Citation: BMC Primary Care 2024 25:243
  4. Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to...

    Authors: Samuel Thio, Azeb Gebresilassie Tesema, Bindu Patel, Unise Vakaloloma, Colleen Wilson and Rohina Joshi
    Citation: BMC Primary Care 2024 25:228
  5. Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltrea...

    Authors: Astrid Durdei Midtsund, Lena Henriksen, Mirjam Lukasse and Lisbeth Valla
    Citation: BMC Primary Care 2024 25:218
  6. Individuals living in communities with poor access to healthcare may be unaware of their high blood pressure (BP). While the use of community health workers (CHWs) can address gaps in human resources for healt...

    Authors: Andrew Kwiringira, Richard Migisha, Lilian Bulage, Benon Kwesiga, Daniel Kadobera, George Upenytho, Paul Mbaka, Julie R. Harris, Donald Hayes and Alex R. Ario
    Citation: BMC Primary Care 2024 25:191
  7. Community health workers (CHW) are an integral part of primary health care re-engineering in South Africa. Cape Town is developing community-orientated primary care, with a central role for CHWs. Their role in...

    Authors: Lize-Marie Doresha, Williams and Robert Mash
    Citation: BMC Primary Care 2024 25:176
  8. Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to recor...

    Authors: Winnifred K. Kansiime, Edwinah Atusingwize, Rawlance Ndejjo, Emmanuel Balinda, Moses Ntanda, Richard K. Mugambe and David Musoke
    Citation: BMC Primary Care 2024 25:173
  9. This research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transitio...

    Authors: Xinyi Xu, Jingyi Huang, Xiaoqian Zhao, Yumin Luo, Linxuan Wang, Yishan Ge, Xingyin Yu and Pinghua Zhu
    Citation: BMC Primary Care 2024 25:154
  10. In recent years, health systems have expanded the focus on health equity to include health-related social needs (HRSNs) screening. Community health workers (CHWs) are positioned to address HRSNs by serving as ...

    Authors: Kevin P. Fiori, Samantha Levano, Jessica Haughton, Renee Whiskey-LaLanne, Andrew Telzak, Hemen Muleta, Kavita Vani, Earle C. Chambers and Andrew Racine
    Citation: BMC Primary Care 2024 25:140
  11. Village health volunteers (VHVs) engaging in community-based COVID-19 prevention and control measures played a key role in mitigating effects of the COVID-19 pandemic in Thailand. We conducted a cross-sectiona...

    Authors: Paleeratana Wongrith, Phuwasin Buakate, Lateefah Doylee, Naseeyah Phonla, Omid Dadras and Geoff Frampton
    Citation: BMC Primary Care 2024 25:102
  12. Community health workers (CHWs) have demonstrated capability to improve various health indicators, however, many programmes require support in meeting their objectives due to subpar performance and a high rate...

    Authors: Sofwatun Nida, Agatha Swasti Ayuning Tyas, Nidya Eka Putri, Ayudina Larasanti, Aldhea Ayu Widoyopi, Rima Sumayyah, Saetia Listiana and Aufia Espressivo
    Citation: BMC Primary Care 2024 25:82
  13. China is implementing the family doctor (FD) system to reform the primary healthcare (PHC). The family doctor contract service (FDCS) policy plays a crucial role in this system implementation, aiming to transf...

    Authors: Linni Gu, Xiaoying Wang and Donghua Tian
    Citation: BMC Primary Care 2024 25:58
  14. Inspired by examples in low- and middle-income countries, 50 community health workers (CHWs) were introduced in Belgium to improve access to primary care for people living in socio-economically vulnerable circ...

    Authors: Caroline Masquillier and Theo Cosaert
    Citation: BMC Primary Care 2023 24:281
  15. Hypertension is a major health problem globally and in India. Around 60% of people with hypertension in India are not aware that they have the condition. Less than 30% of individuals with hypertension are on t...

    Authors: Samir Garg, Mukesh Dewangan, Prabodh Nanda, Ashu Sahu, Lalita Xalxo, Kirtti Kumar Bebarta, Vishnu Gupta, Mohammad Jawed Quereishi, Anand Kumar Sahu and Pradeep Tandan
    Citation: BMC Primary Care 2023 24:272
  16. Community health workers (CHWs) have helped improve access to quality primary health care (PHC). However, knowledge gaps exist in designing and implementing CHW-engaged models needed to ensure quality people-c...

    Authors: Lisa R Hirschhorn, Indiran Govender and Joseph M Zulu
    Citation: BMC Primary Care 2023 24:219

Submission Guidelines

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This Collection welcomes submission of original Research Articles. Should you wish to submit a different article type, please read our submission guidelines to confirm that type is accepted by the journal. Articles for this Collection should be submitted via our submission system, Snapp. During the submission process you will be asked whether you are submitting to a Collection, please select "The role of community health workers in primary care" from the dropdown menu.

Articles will undergo the journal’s standard peer-review process and are subject to all of the journal’s standard policies. Articles will be added to the Collection as they are published.

The Guest Editors have no competing interests with the submissions which they handle through the peer review process. The peer review of any submissions for which the Guest Editors have competing interests is handled by another Editorial Board Member who has no competing interests.