Policy Brief: Community Health Workers in Humanitarian Settings

As the first level of frontline health workers in many fragile and humanitarian settings, community health workers (CHWs) can be key to promoting health system and community resilience, the continuation of essential services, and effective emergency response. However, the challenges to implementing community-based primary healthcare in a humanitarian setting can be daunting. More evidence is needed on what service delivery strategies and tools can help ensure continued availability and quality of services, high utilisation of services by the population, and strong linkages with the broader health system.

To better understand the barriers and enabling factors for community-based service delivery through CHWs, UNICEF, Save the Children, and the International Rescue Committee have collaborated to conduct a number of studies to document experiences with CHW services in humanitarian settings in low- and middle-income countries. Retrospective case studies were carried out in Guinea, Liberia, and Sierra Leone (Ebola outbreak); South Sudan (conflict); Bangladesh (flooding); and Yemen (conflict). Additionally, a scoping review of peerreviewed and grey literature on community health workers in humanitarian settings was conducted, including 219 relevant documents. Published articles and upcoming publications can be accessed at the Journal of Global Health collection on community health in emergencies: http://www.jogh.org/col-emergencies.htm

Based on the findings from the case studies and the literature review, this policy brief summarizes the key lessons learned regarding CHWs in humanitarian settings. This information is of particular importance in the current context, as countries respond to the COVID-19 pandemic.