ArticleBMJ global health2025
Costs and cost-effectiveness of integrated horizontal community health worker programmes in low- and middle-income countries (2015-2024): a scoping literature review.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Decision-analytic models in the economic evaluation of community health worker programmes globally: a systematic review.BMJ global health · 2026Pooled it
- Return on investment of community health workers in the United States: a systematic review.Lancet regional health. Americas · 2026Article
- Resolving the vertical versus horizontal conundrum: the potential of a "next generation" community health worker program to accelerate progress in TB control and at the same time strengthen primary health care.Frontiers in public health · 2026Article
- "The satisfaction we get by doing this, you do not get it with any money": Experiences, and motivations of, and strategies used by community volunteers delivering social or health interventions in India.PLOS global public health · 2026Article
- Costs and cost-effectiveness of community health worker programs on reproductive, maternal, newborn and child health in low- and middle-income countries (2015-2024): A scoping review.PLOS global public health · 2026Article
- Costs and cost-effectiveness of community health worker programmes focussed on non-communicable diseases in low- and middle-income countries (2015-2024): a scoping literature review.BMJ global health · 2025Article
- Costs and cost-effectiveness of community health worker programs focussed on HIV, TB and malaria infectious diseases in low- and middle-income countries (2015-2024): A scoping literature review.PLOS global public health · 2025Article
- Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015-2024): A scoping literature review.PLOS global public health · 2025Article
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Authors and funding
29 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity health workers (CHWs) play a vital role in delivering primary health care in low- and middle-income countries (LMICs), addressing multiple diseases through horizontal programmes. Despite their effectiveness, there is a US$4.4 billion annual funding gap for professional CHW programmes. Some countries have adopted these programmes, while others require stronger economic evidence to justify investments. This study updates a 2015 review, critically examining the costs and cost-effectiveness of horizontal CHW programmes in LMICs.
methodsA scoping review was conducted using 10 databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to 'Community Health Workers' and 'Economic Evaluations' were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, cost and outcomes were extracted, tabulated in Microsoft Excel and analysed.
resultsA total of 18 studies, covering 42 scenarios, were included. Most studies focused on partial economic evaluations, with cost analyses being the most common method. CHW compensation varied widely, with a median monthly salary of US$265 (range US$3033 ($148 (Ethiopia)-$3181 (Malawi)); IQR US$346 (US$203-US$549)). The most commonly reported cost metric was the annual cost per capita, with a median of $6.02 (range: $0.29-$67.95). Sensitivity analyses were conducted in 29% of the scenarios, with six scenarios concluding CHW programmes were cost-effective. However, most did not conclude on cost-effectiveness or affordability, highlighting gaps in the evidence base. Service provision was the most frequently reported outcome, while cost per outcome and affordability were under-reported.
conclusionsThis review highlights gaps in the economic evaluation of horizontal CHW programmes, particularly in cost-effectiveness and affordability. More large-scale evaluations are needed to inform national health policies and support sustained investment in CHW programmes to strengthen health systems and address workforce shortages.
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