In the health sector we are facing a double challenge; there is a shortage of formal health workers and a concurrent push to scale up programmes to meet targets such as Universal Health Coverage and the Millennium Development Goals. Working with Community Health Workers (CHWs) is thought to be a potential solution. Ensuring that CHWs are properly supported is vital if they are to fulfill the critical role they can play in improving the health of communities. There are management challenges associated with CHW programmes, including attracting recruits, turnover and performance. A range of different health actors are involved in managing and coordinating CHWs. Health service or programme managers are often responsible for overall programme delivery. Frontline supervisors have responsibility for implementing practices relating to performance management. Community organisations, such as village health committees, may be involved in the selection and recruitment of CHWs and some monitoring of performance. To maximize support to CHWs, these three groups need to work together closely, despite the different contexts in which they work.
