Our evidence-based recommendations are intended to help other CHW programs achieve success at scale. These recommendations do not aim to create a one-size-fits-all approach to designing CHW programs. Rather, they reflect our understanding that what makes CHW programming so valuable is its flexibility to address the needs and context in which they are situated. There exist a variety of program models, each for a different setting, that optimize CHW effectiveness. There is no ideal setting and no ideal programmatic model. In fact, our research indicates that adapting CHW programs to local contexts is critical. At the same time, there are certain policies and strategies that can help leaders design and develop effective CHW programs to suit their specific context and health priorities.
Leaders seeking to design or strengthen CHW programing to achieve optimal health outcomes should consider the following five universal recommendations. In this section, context-specific findings, which may – under certain circumstances – provide important guidance to improve program performance and health outcomes, can be found.