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Retreat from Alma Ata?: the WHO's report on task shifting to community health workers for AIDS care in poor countries

Campbell, Catherine and Scott, Kerry (2011) Retreat from Alma Ata?: the WHO's report on task shifting to community health workers for AIDS care in poor countries. Global Public Health, 6 (2). pp. 125-138. ISSN 1744-1692

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Identification Number: 10.1080/17441690903334232


This paper examines the potential of community health worker (CHW) programmes, as proposed by the 2008 World Health Organisation (WHO) document Task Shifting to tackle health worker shortages, to contribute to HIV/AIDS prevention and treatment and various Millennium Development Goals in low-income countries. It examines the WHO proposal through a literature review of factors that have facilitated the success of previous CHW experiences. The WHO has taken account of five key lessons learnt from past CHW programmes (the need for strong management, appropriate selection, suitable training, adequate retention structures and good relationships with other healthcare workers). It has, however, neglected to emphasise the importance of a sixth lesson, the 'community embeddedness' of CHWs, found to be of critical importance to the success of past CHW programmes. We have no doubt that the WHO plans will increase the number of workers able to perform medically oriented tasks. However, we argue that without community embeddedness, CHWs will be unable to successfully perform the socially oriented tasks assigned to them by the WHO, such as health education and counselling. We locate the WHO's neglect of community embeddedness within the context of a broader global public health trend away from community-focused primary healthcare towards biomedically focused selective healthcare.

Item Type: Article
Official URL:
Additional Information: © 2011 Taylor & Francis
Divisions: LSE Health
Psychological and Behavioural Science
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 16 Feb 2011 12:11
Last Modified: 03 Apr 2024 20:48

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