Learning How Not to Train the Community Out of the Community Health Workers

Community health workers (CHW) are often trained through a series of initial classes followed by continuing education opportunities. While this classic structure is invaluable for ensuring that the CHW has access to the right knowledge so that they can develop the right skills and attitudes to do their job, this chapter argues that this is insufficient. An equally as important and influential determinant of how the CHW will work will be the quality of the job and the quality of the health system to which they contribute. This is part of the ‘hidden curriculum’, and it is too often underappreciated when planning to train CHWs. CHWs are often seen as a cheaper solution to help meet the human resources for health crisis, but this chapter argues that if they are only given medical tasks, and if their role is medicalized to the point of removing them from how their communities function, then health systems will lose access to important opportunities to improve quality and healthcare outcomes.