Publication Date


Degree Name

Master of Arts (MA)


Previous studies revealed that the institution of voluntary community health workers (CHWs) created many problems. Trained CHWs started demanding salaries and other forms of remuneration. Some CHWs volunteer, hoping that the work will lead to some form of formal employment. Furthermore, the work of the CHW was not often appreciated or respected and they have minimal support and supervision. These problems are causing high attrition and low activity rates. It also caused some primary health care projects to fail.

This paper looks at how support and compensation for CHWs can be sustained. A total of 125 CHWs (85 active and 40 non-active) were interviewed. The study concluded that: the idea of CHWs were not properly introduced; CHWs are frustrated and do not agree with the concept of voluntarism; CHWs are willing to help themselves and become sustainable in the process, but lack the necessary financial and technical support; there is a definite need for supervision and continuing education; and there exists poor communication between the formal health system, project implementors and the CHWs.


Community Health and Preventive Medicine