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close this bookEducation for Health (WHO, 1988, 274 p.)
close this folderChapter 6: Health education with communities
View the document(introduction...)
View the documentWhat is a community?
View the documentWhen is community health education needed?
View the documentGetting opinion leaders involved
View the documentThe role of local organizations
View the documentThe community health committee
View the documentAdvisory and planning boards
View the documentIntersectoral coordination groups
View the documentOrganizing a health campaign
View the documentSpecial community events
View the documentMobilizing community resources for a project
View the documentDeveloping a partnership with people
View the documentThe role of the community health worker

The role of the community health worker

One of the most important ways of providing health education to a community is through the selection and training of community health workers.

Functions of a community health worker

The community health worker comes from the community and is trained to work in it, in close relationship with the health care system. The community health worker is expected to perform a wide range of functions, which generally include: home visits, environmental sanitation, provision of an adequate and safe water supply, first aid and treatment of simple and common ailments, health education, nutritional surveillance, maternal and child health and family planning activities, communicable diseases control, community development activities, referrals, record keeping, and collection of data on vital events.

These functions have been shaped to a large extent by the Declaration of Alma-Ata, which outlined the eight essential components of primary health care as being: education concerning prevailing health problems and the methods of preventing and controlling them; promotion of food supply and proper nutrition: an adequate supply of safe water and basic sanitation; maternal and child health care, including family planning; immunization against the major infectious diseases; prevention and control of locally endemic diseases; appropriate treatment of common diseases and injuries; and provision of essential drugs.

Community health workers are in a unique position because they have a role both in the community and within the health care system. They make a bridge between one and the other. In the community they help to identify problems, and people at risk or in need. They involve the community in planning how to deal with its own problems, and they help the community to be in touch with the health services. The community health worker also provides the health services with the information needed for surveillance, planning, and management.

Training and supervision

The training and supervision of community health workers are among the primary health care tasks in which health education has a major part to play. Through health education, we must make sure that the community is involved in selecting its health workers. Through discussion with the trainees, we should agree on a time and place that is convenient for the training. Local communication and education methods should be used in the training to aid understanding. Trainers should learn how the local culture views health, and specific diseases, so that local beliefs and customs can be effectively discussed during training.

The community health worker acts as a 'bridge' between the community and the health services, and plays a key role in helping the community express its needs and develop self-reliance.

The concept of the community health worker is an important advance in finding ways to make health care accessible to all.

Many, if not most, community health workers are volunteers. They may be paid little or nothing for their work. They need regular support from supervisory staff, such as a community nurse or public health inspector, to help them keep up their morale. The supervisors should help the community health workers remember their tasks. They should also help inform the community about the community health workers' jobs and encourage the community to support their work. We should be careful not to expect too much from community health workers who are volunteers. We should give them constant encouragement and praise when it is due, because without these workers at the grassroots level there would be no primary health care.

A villager volunteers to be a health worker.