Rethinking Community Health Worker Training in Indonesia: A Call for Contextualisation

ABSTRACT

Since late 2021, Indonesia's health transformation agenda has called for a more active role for more than 1.4 million health cadres (the local term for community health workers in Indonesia) in primary health care efforts. However, far prior to this agenda, unlocking health cadres' full potential remains an ongoing challenge in the country. Training of health cadres has remained largely based on standardised national approaches, regardless of the rich variations in geographical, socio‐cultural, infrastructural, and governance‐related contexts within the country. Efforts to contextualise their training are therefore essential to accommodate these gaps, but little discussion has been given to this matter. Drawing on a three‐fold conceptualisation of the role of community health workers (as service extenders, cultural brokers, and social‐change agents), this article presents a comprehensive discussion on why health cadres' roles remain suboptimally performed, what is required to contextualise training to strengthen these roles, including how training may contribute to surmounting the contextual constraints on their ability to perform each of these roles optimally. Drawing on discussions across each of cadres' roles, this article concludes that to enhance the impact of cadres' contributions, training should be grounded in local contexts, place stronger emphasis on communication and community engagement capabilities, and be supported by collaboration across the broader social system and public sectors. Future training should complement existing standardised approaches with context‐sensitive strategies. Without this, efforts to improve cadres' performance are unlikely to yield the intended impact.