Time to prioritise community health workers: a decade of cost-effectiveness evidence

Governments in low-income and middle-income countries face a stark challenge: delivering quality health care within the shrinking fiscal space. Many governments default to facility-based, curative investments, yet this model alone cannot deliver universal health coverage. Hospitals often struggle to reach remote communities, deliver preventive care, and address social and behavioural drivers of disease—areas in which community health workers (CHWs) excel. When CHWs are adequately trained, supervised, supported, and compensated, they can improve health outcomes, lower costs, reduce inequities, and strengthen health systems.