abstract: 'Background: Developing countries have the potential to reach vulnerable

  and underserved populations marginalized by the country''s health care

  systems by way of community health workers (CHWs). It is imperative that

  health care systems focus on improving access to quality continuous

  primary care through the use of CHWs while paying attention to the

  factors that impact on CHWs and their effectiveness.

  Objective: To explore the possible opportunities and challenges of

  integrating CHWs into the health care systems of developing countries.

  Methods: Six databases were examined for quantitative, qualitative, and

  mixed-methods studies that included the integration of CHWs, their

  motivation and supervision, and CHW policy making and implementation in

  developing countries. Thirty-three studies met the inclusion criteria

  and were double read to extract data relevant to the context of CHW

  programs. Thematic coding was conducted and evidence on the main

  categories of contextual factors influencing integration of CHWs into

  the health system was synthesized.

  Results: CHWs are an effective and appropriate element of a health care

  team and can assist in addressing health disparities and social

  determinants of health. Important facilitators of integration of CHWs

  into health care teams are support from other health workers and

  inclusion of CHWs in case management meetings. Sustainable integration

  of CHWs into the health care system requires the formulation and

  implementation of polices that support their work, as well as financial

  and nonfinancial incentives, motivation, collaborative and supportive

  supervision, and a manageable workload.

  Conclusions: For sustainable integration of CHWs into health care

  systems, high-performing health systems with sound governance, adequate

  financing, well-organized service delivery, and adequate supplies and

  equipment are essential. Similarly, competent communities could

  contribute to better CHW performance through sound governance of

  community resources, promotion of inclusiveness and cohesion, engagement

  in participatory decision making, and mobilization of local resources

  for community welfare.'
affiliation: 'Wang, W (Corresponding Author), Edith Cowan Univ, Sch Med Sci, Global
  Hlth \& Genom, Joondalup, WA 6027, Australia.

  Asweto, Collins Otieno; Alzain, Mohamed Ali; Andrea, Sebastian; Wang, Wei, Capital
  Med Univ, Sch Publ Hlth, Beijing, Peoples R China.

  Asweto, Collins Otieno, Great Lakes Univ Kisumu, Sch Hlth Sci, Kisumu, Kenya.

  Asweto, Collins Otieno; Alzain, Mohamed Ali; Andrea, Sebastian; Wang, Wei, Beijing
  Municipal Key Lab Clin Epidemiol, Beijing, Peoples R China.

  Alzain, Mohamed Ali, Univ Dongola, Fac Med \& Hlth Sci, Community Med Dept, Dongola,
  Sudan.

  Alexander, Rachel; Wang, Wei, Edith Cowan Univ, Sch Med Sci, Syst \& Intervent Res
  Ctr Hlth, Perth, WA, Australia.'
author: Asweto, Collins Otieno and Alzain, Mohamed Ali and Andrea, Sebastian and Alexander,
  Rachel and Wang, Wei
author-email: wei.wang@ecu.edu.au
author_list:
- family: Asweto
  given: Collins Otieno
- family: Alzain
  given: Mohamed Ali
- family: Andrea
  given: Sebastian
- family: Alexander
  given: Rachel
- family: Wang
  given: Wei
da: '2023-09-28'
doi: 10.15212/FMCH.2016.0102
eissn: 2009-8774
files: []
issn: 2305-6983
journal: FAMILY MEDICINE AND COMMUNITY HEALTH
keywords: 'Community health workers; health care systems and policy; supportive

  supervision; developing countries'
keywords-plus: 'INCOME COUNTRIES; PERFORMANCE; FACILITATORS; SURVIVAL; NEWBORN; PROGRAM;

  AFRICA; MIDDLE'
language: English
month: JAN 1
number: '1'
number-of-cited-references: '52'
orcid-numbers: 'Alzain, Mohamed Ali/0000-0002-0085-5805

  '
pages: 37-45
papis_id: 7cbf374057c592d2608c8a3ee0ebe875
ref: Asweto2016integrationcommunity
researcherid-numbers: 'Alzain, Mohamed Ali/AAF-5957-2019

  Alzain, Mohamed Ali/AAR-8314-2021

  ASWETO, COLLINS/AAK-7261-2021'
tags:
- review
times-cited: '14'
title: 'Integration of community health workers into health systems in developing
  countries: Opportunities and challenges'
type: Review
unique-id: WOS:000448223900006
usage-count-last-180-days: '1'
usage-count-since-2013: '5'
volume: '4'
web-of-science-categories: Primary Health Care
year: '2016'