The role of community health workers in primary healthcare in the WHO-EU region: a scoping review

Tijs Van Iseghem; Ilka Jacobs; Dorien Vanden Bossche; Peter Delobelle; Sara Willems; Caroline Masquillier; Peter Decat

doi:10.1186/s12939-023-01944-0

The role of community health workers in primary healthcare in the WHO-EU region: a scoping review

Int J Equity Health. 2023 Jul 20;22(1):134. doi: 10.1186/s12939-023-01944-0.

Authors

Tijs Van Iseghem¹, Ilka Jacobs², Dorien Vanden Bossche³, Peter Delobelle^{4

5}, Sara Willems², Caroline Masquillier⁶, Peter Decat³

Affiliations

¹ Interuniversity Centre for Health Economics Research (ICHER), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. tijs.vaniseghem@ugent.be.
² Equity Research Group, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
³ Unit Family Medicine, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
⁴ Chronic Diseases Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa.
⁵ MENT Research Group, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium.
⁶ 'Family Medicine and Population Health' - FAMPOP, Faculty of Medical Sciences & 'Centre for Family, Population and Health', Faculty of Social sciences, University of Antwerp, Antwerp, Belgium.

Abstract

Background: Existing evidence on the role of community health workers (CHWs) in primary healthcare originates primarily from the United States, Canada and Australia, and from low- and middle-income countries. Little is known about the role of CHWs in primary healthcare in European countries. This scoping review aimed to contribute to filling this gap by providing an overview of literature reporting on the involvement of CHWs in primary healthcare in WHO-EU countries since 2001 with a focus on the role, training, recruitment and remuneration.

Methods: This systematic scoping review followed the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses, extension for Scoping Reviews. All published peer-reviewed literature indexed in PubMed, Web of Science, and Embase databases from Jan 2001 to Feb 2023 were reviewed for inclusion. Included studies were screened on title, abstract and full text according to predetermined eligibility criteria. Studies were included if they were conducted in the WHO-EU region and provided information regarding the role, training, recruitment or remuneration of CHWs.

Results: Forty studies were included in this review, originating from eight countries. The involvement of CHWs in the WHO-EU regions was usually project-based, except in the United Kingdom. A substantial amount of literature with variability in the terminology used to describe CHWs, the areas of involvement, recruitment, training, and remuneration strategies was found. The included studies reported a trend towards recruitment from within the communities with some form of training and payment of CHWs. A salient finding was the social embeddedness of CHWs in the communities they served. Their roles can be classified into one or a combination of the following: educational; navigational and supportive.

Conclusion: Future research projects involving CHWs should detail their involvement and elaborate on CHWs' role, training and recruitment procedures. In addition, further research on CHW programmes in the WHO-EU region is necessary to prepare for their integration into the broader national health systems.

Keywords: Community health workers; Primary healthcare; WHO-EU region.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Community Health Workers*
Educational Status
Humans
Primary Health Care*
United Kingdom
World Health Organization