Competency-Based Training Empowers Community Health Workers

by Jon Scaccia March 10, 2025

What if the key to solving some of the world’s most persistent healthcare challenges lies with community members themselves? Community Health Workers (CHWs) have long been the unsung heroes of global health, bridging the gap between formal healthcare systems and the communities they serve. A recent scoping review sheds light on how competency-based education (CBE) is transforming CHW training, promising to enhance healthcare delivery and outcomes worldwide.

The Research: Why Competency-Based Education Matters

The study reviewed over 700 articles to understand how, where, and by whom CHWs are trained using CBE methods. While traditional training often focuses on knowledge retention, CBE emphasizes real-world application—like problem-solving, decision-making, and practical skill development. This approach is critical as CHWs take on increasingly complex roles, from managing chronic diseases to conducting health screenings.

One of the standout findings from the review is that CBE not only improves CHWs’ technical skills but also enhances their ability to adapt to local cultural contexts. Programs that were co-designed with CHWs themselves and tailored to low-literacy learners were notably effective in converting training into practice. However, the review also exposed significant gaps—particularly the lack of institutional support, career progression opportunities, and integration of CHWs into formal health systems.

Turning Knowledge into Action: Real-World Applications

Imagine a CHW in rural Malawi, trained through a competency-based program, identifying early signs of malnutrition in children during routine home visits. Instead of just recording data, they apply their training to educate caregivers, connect families to local food programs, and monitor progress over time. This proactive approach, reinforced by CBE, translates learning into measurable health outcomes.

The research emphasizes that when training aligns with CHWs’ real-world challenges, it empowers them to make a tangible difference. For example, programs that integrate experiential learning—like role-playing and home visit simulations—prepare CHWs to handle scenarios ranging from emergency response to mental health support.

Contextualizing the Findings: Why Now?

The need for well-trained CHWs is more urgent than ever. The World Health Organization (WHO) predicts a global shortfall of 10 million health workers by 2030. Many countries, including Brazil, Ethiopia, and India, have demonstrated the profound impact of CHWs on improving maternal and child health, managing infectious diseases, and supporting chronic care.

Yet, the literature predominantly highlights small-scale, ad hoc training programs, primarily in high-income countries like the USA. This focus underscores a missed opportunity to scale CBE within national CHW programs in low- and middle-income countries, where the healthcare need is often greatest. More robust, large-scale initiatives could significantly boost global progress toward Universal Health Coverage and the Sustainable Development Goals.

What’s Next? Challenges and Opportunities

To unlock the full potential of CBE for CHWs, several challenges need to be addressed:

• Institutional Support: Training programs must go hand-in-hand with career progression opportunities and fair compensation for CHWs.
• Scalability: There is a pressing need to transition from small-scale pilot programs to national-level initiatives, especially in low-resource settings.
• Research Gaps: More evidence is needed on how CBE impacts not only CHWs’ skills but also broader health outcomes in their communities.

Future research should also explore how integrating CHWs into formal health systems through credentialing and consistent support could elevate their role from frontline helpers to recognized healthcare professionals.

Join the Conversation

What role do you see Community Health Workers playing in your community? How could competency-based training improve healthcare delivery where you live or work? What challenges might arise in implementing large-scale CBE programs for CHWs? Share your thoughts in the comments or join the discussion on social media!

By investing in CHWs and empowering them through competency-based education, we can build stronger, healthier communities—one skill at a time.

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