Cost-effectiveness of village health workers

Helpdesk Query:

Provide a review of evidence of the cost effectiveness of village health workers (VHWs) in improving coverage of health services, and improving health status, with reference to VHW programmes that are comparable to the VHW in Zimbabwe and the Zimbabwe context.


This report reviews the evidence of the cost effectiveness of village health workers. It found that the literature tends to use the term community health workers (CHWs) generally to encompass village health workers and other regional variations of a similar role. The reviews on this topic often use the term broadly where country programs operate differently in terms of amount of training, payment and other operational details. Section 2 of this report draws conclusions from reviews which don’t necessarily distinguish between different program types. Further sections aimed to draw on examples from programs similar to the Zimbabwe VHW program, ie. 3-8 weeks training and similar roles.

Studies finding community health worker programmes to be more cost effective compared to other strategies were identified from Bangladesh, Nepal, and Myanmar. An operational model devised by the CHW task force at the Earth Institute (2013) estimated costing of a CHW program per population served, per year for Zimbabwe to be $6.61.

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