Journal of Community Health

, Volume 30, Issue 3, pp 221–229 | Cite as




Since the Alma-Ata Conference in 1978 reiterated the goal of “Health for All by the Year 2000”, health service delivery programs promoting the primary health care approach using community health workers (CHWs) have been established in many developing countries. These programs are expected to improve the cost-effectiveness of health care systems by reaching large numbers of previously under-served people with high-impact basic services at low cost. However, there is a dearth of data on the cost-effectiveness of CHW programs to confirm these views. This may be because conventional approaches to economic evaluation, particularly cost-effectiveness, tend not to capture the institutional features of CHW programs. Therefore, this paper aims to examine the means by which economic methods can be extended to provide evidence regarding the cost-effectiveness of CHWs in developing countries.


community health workers  cost-effectiveness  review 


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Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  1. 1.Health Economics and Financing Program, Health Policy Unit, Department of Public Health and PolicyLondon School of Hygiene & Tropical MedicineLondonUK

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