Do lay or community health workers in primary health care improve maternal, child health and tuberculosis outcomes?

Lay health workers have no formal professional education, but are usually given job-related training, and can be involved in either paid or voluntary care. They perform diverse functions related to health care delivery and have a range of titles, including village health workers, community volunteers and peer counsellors.

Key messages

• The use of lay health workers in maternal and child health programmes: Probably leads to an increase in the number of women who breastfeed
  • Probably leads to an increase in the number of children with up-to-date immunisation schedule.
  • May lead to fewer deaths among children under five years
  • May lead to fewer children who suffer from fever, diarrhoea and pneumonia
  • May increase the number of parents who seek help for their sick child

• The use of lay health workers in tuberculosis programmes:
  • Probably leads to an increase in the number of people with tuberculosis who are cured
  • Probably makes little or no difference to the number of people who complete preventive treatment for tuberculosis

• Little evidence is available regarding the effectiveness of substituting lay health workers for health professionals or the effectiveness of alternative strategies for training, supporting and sustaining lay health workers

• Factors that need to be considered when assessing whether intervention effects are likely to be transferable to other settings include:
  • The availability of routine data on who might benefit from the intervention
  • The availability of resources for the lay health worker programme, for clinical and managerial support, and for supplies