Session 2 Overview: Current Issues for the CHW Workforce

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CHWs at a planning session.

The objectives for this session include:

  • Describe the current status of the CHW occupation
  • Name at least six major issues within the CHW field
  • Discuss the central importance of community vs. institutional accountability in the role of the CHW



In this session, we will look further at some of the subtleties of the CHW workforce that anyone intending to work on CHW workforce policy must understand.

These “fine points” are important in explaining the CHW workforce effectively to stakeholders and in working with CHWs themselves in a responsive and respectful way.

The CHW has often been described as an “emerging occupation.” What does this mean? We will look at employment conditions for CHWs and recognition of the CHW as an occupation. To clarify the dynamics of CHW organizations and the actions and beliefs of individual CHWs involved in policy action, we will look at a range of issues being discussed and debated within the field.

We will examine one of these issues in more detail: To whom is the CHW accountable? Accountability is a central theme, and a possible dilemma, in the nature of the CHW and her relationship to community and employer. If a CHW’s effectiveness depends on a special relationship with the community, does her accountability to an employer create divided loyalties? By pressuring a CHW to meet institutional objectives, does the employer risk losing the unique benefits of the CHW’s community connection?