Community health workers and accountability: Reflections from an international "think-in"

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

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


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.

Original languageEnglish
Article number66
JournalInternational Journal for Equity in Health
Issue number1
StatePublished - 25 May 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 The Author(s).


This work was funded by the John D. and Catherine T. MacArthur Foundation, the Ford Foundation, and the William and Flora Hewlett Foundation.

FundersFunder number
Ford Foundation
John D. and Catherine T. MacArthur Foundation
William and Flora Hewlett Foundation


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


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