Roles and Scope of Work

  • Bridging cultural mediation between communities and the health care system
  • Providing culturally appropriate and accessible health education and information, often by using popular education methods
  • Ensuring that people get the services they need
  • Providing informal counseling/education and social support
  • Advocating for individuals and communities
  • Providing direct services (such as basic first aid)  and administering health screening tests
  • Building  individual and community capacity

The essential scope of work for a CHW is primary healthcare prevention and control of chronic disease among underserved populations.

Level of Prevention Aim Phase of Disease Target Intervention Examples
Primary Widespread changes that reduce the average risk in the whole population.
Reduction of particular exposures among identified higher risk groups or individuals
Specific causal factors associated with the onset of disease.
Specific and non-specific factors associated with protection against disease
Total population, selected groups and healthy individuals Measures that eliminate or reduce the causes or determinants of departures from good health, control exposure to risk, and promote factors that are protective of health:

  • Systematic immunization to eliminate communicable disease
  • Education programs to increase awareness of the risks of physical inactivity and poor diet to reduce the burden of preventable chronic disease
  • Legislation to require wearing of seat belts to reduce the incidence of death and disability associated with road trauma
  • Tobacco control programs
Adapted from Beaglehole R, Bonita R, Kjellstrom T (1993). Basic Epidemiology. Geneva, World Health Organization. Brownson, R, Remington, P & Davis J (Eds) (1998). Chronic Disease Epidemiology and control, (2nd Edition) American Public Health Association, Washington DC

In the prevention and control of chronic disease, primary prevention for CHWs may look like the following:

Prevention and control of chronic disease

  • Support to multidisciplinary health teams
  • Outreach to individuals in the community setting
  • Educating the patient and their families on the importance of lifestyle change; adherence to their medication regimes and recommended treatments
  • Find creative ways to increase compliance with medications
  • Help patients navigate the healthcare system; enrollment  eligibility, appointments, referrals; transportation, promoting continuity of care
  • Providing social support by listening to concerns of the patient and their family
  • Helping with problem solving strategies
  • Assessment of how well a self- management  plan is helping the patient meet their own health goals
  • Assisting clients in obtaining home health devices to support self-management
  • Supporting individualized goal setting using motivational interviewing.