The Lives of Community Health Workers: Local Labor and Global Health in Urban Ethiopia by Kenneth Maes

Abstract

National experiences with community health workers (CHWs) and evidence about their effectiveness in improving the health of populations is growing rapidly throughout the world—from the prototype of the first CHW cadre using “farmer scholars” in China in the 1930s at Ding Xian,1 to the current state of affairs where there are now more than five million CHWs providing basic and essential health care services around the world, including in the United States.2 CHWs are now widely recognized as a critical resource for enabling health systems to more effectively improve the health of the populations they serve and to reduce health inequities, especially in underserved geographic areas.3 The evidence—that CHWs can save lives through promoting healthy household behaviors and good nutrition, linking families to important preventive services such as immunizations, recognizing danger signs for which treatment should be sought, providing treatment for life-threatening illnesses (such as HIV/AIDS and childhood pneumonia, the leading single cause of child death globally), and accompanying patients to health facilities for emergency care—has been rapidly accumulating during the past two decades. New evidence will certainly continue to accumulate on the effectiveness of CHWs in disease surveillance (to detect outbreaks of Ebola and other serious highly contagious diseases), in ending the HIV/AIDS epidemic and providing ongoing treatment to infected patients, in controlling tuberculosis and malaria, and in detecting and treating important emerging noncommunicable diseases such as hypertension, diabetes, and mental illness throughout the world.4 Kenneth Maes’s new book makes an important contribution to a void in the literature on CHWs—studies of CHWs themselves as people and of their perspectives on their work. Zulfiqar Bhutta Z, Zohra S. Lassi, George Pariyo, et al., Global Experience of Community Health Workers for Delivery of Health Related Millennium Developmental Goals: A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems (Geneva: World Health Organization, 2010), http://www.who.int/workforcealliance/knowledge/publications/alliance/Global_CHW_web.pdf (accessed January 6, 2018).