Roles, Skills, and Qualities of Community Health Workers

Abstract

Community health workers (CHWs) possess a set of core roles and competencies that make them distinct from other health professionals. The way these roles and competencies are understood and practiced is different from that of other health professionals. Differences between the CHW profession and other professions are rooted in how the profession developed in response to social and health inequities. CHW roles are unusually broad and flexible compared to other health professions. This can present challenges when CHWs are integrated into the hierarchical medical system, yet ensuring that CHWs can continue to play a wide range of roles is essential. Similarly, the combination of qualities, skills, and knowledge CHWs need in order to be effective in their roles does not fit neatly into a conventional competency-based framework. When asked about the skills and qualities they need to do their work, CHWs tend to emphasize personal qualities over skills gained through training. Recent research has reinforced the idea that what program participants most value in CHWs are interpersonal qualities like being friendly, respectful, and nonjudgmental. By clearly differentiating between roles, skills, and qualities and respecting the unique importance of each, we can help to assure that CHWs are able to make optimal contributions to communities, social justice, and health and social service systems.

Portions of this chapter are adapted from: Wiggins, N., & Borbón, I. A. (1998). Core roles and competencies of Community Health Workers. In Final report of the National Community Health Advisor Study (pp. 15–49). Baltimore, MD: Annie E. Casey Foundation.