A Modular Analysis of National CHW Curricula from Select Countries in Sub-Saharan Africa

In response to the compelling evidence on Community Health Worker (CHW) contributions to PHC and UHC, in the past decade, governments across Sub-Saharan Africa (SSA) have intensified efforts to institute/enhance national CHW training programs to equip this workforce with required competencies. However, minimal published evidence is available on the components of national CHW curricula. The study comprised of an initial descriptive analysis of fifteen national CHW curricula, followed by a comparative analysis mapping the content from national CHW curricula with the universal modules and tasks described in the WHO Global Curriculum Guide for CHWs to determine alignment and opportunities for further integration. The descriptive analysis showed variability across all the countries’ curricula, mostly in design, andragogy, and module content, based on health system context and CHW task expectations. Only 47% of the curricula described the training duration, but 60% detailed total learning hours and 67% specified training evaluation methods. Results of the comparative analysis showed that 7-15 of the national curricula aligned with at least 50% of the tasks for the following universal modules in the WHO Global CHW Curriculum Guide: conducting a home visit, providing information and support to impact individual health behaviors, facilitating referrals, assessing community health needs, mobilizing community resources, contributing to program implementation and providing learning opportunities for other CHWs. Few (1-3) national curricula addressed ≥50% of the tasks for modules planning service delivery, supporting/promoting the health needs of individuals and households, supporting/promoting the health needs of communities and assisting with community-based research . As national health systems reconfigure to fully integrate CHWs, to ensure universal coverage of essential PHC services, it is imperative to equip this workforce with key competencies. The WHO Global Curriculum Guide may be considered for future integration in the national curricula, as they can enhance and augment the spectrum of services CHWs can deliver.