Community health workers (CHWs) are the backbone of primary health care in many countries. They provide essential health services, support disease prevention and health promotion, and help communities navigate health systems. Their contribution is critical to achieving universal health coverage, yet their effectiveness depends on having the right skills, support, and integration into the health system.
Despite their importance, CHW training varies widely across countries and contexts. Differences exist in the scope, duration, methods, and quality of pre-service and in-service education, making it difficult to ensure that all CHWs are fully equipped to meet community needs. To address this, the World Health Organization has developed a Global Competency-Based Curriculum Guide for Community Health Workers.
Why a Competency-Based Curriculum?
The curriculum guide operationalizes key recommendations from the WHO CHW guideline, helping governments and partners design, implement, and evaluate CHW programs effectively. It provides practical guidance on:
- Determining the appropriate duration of training based on the role, existing knowledge, and expected practice conditions
- Including comprehensive content, from health promotion and disease prevention to diagnostic and curative services, as well as interpersonal communication and community engagement
- Balancing theory and practice through a mix of face-to-face and e-learning approaches, supported by qualified faculty and a positive training environment
- Certifying CHWs through competency-based formal recognition
The WHO Competency Model
At the heart of the curriculum guide is the WHO competency model, which defines competence as the summative learning outcomes of education programs. It emphasizes two complementary dimensions:
- Practice Activities and Tasks: Core functions of CHWs, such as household mapping, patient referral, and health promotion. These activities are also essential for workforce planning and classification.
- Competencies and Behaviours: The ability to integrate knowledge, skills, and attitudes in performing tasks. This includes collaboration, culturally sensitive care, effective communication, and adaptability in complex contexts.
Competencies are underpinned by foundational knowledge, skills, and attitudes (KSAs). Learning objectives break down each practice activity into the component skills and milestones necessary to develop competence. Education programs aim not only to teach discrete tasks but also to enable CHWs to navigate real-world challenges, make informed decisions, and collaborate with individuals, households, communities, and health systems.
Structure of the Curriculum Guide
The curriculum guide is organized into three sections:
- Core Competencies: Skills that all health workers, including CHWs, should possess, with varying levels of proficiency depending on role and education.
- Universal Modules: Knowledge and practical skills that every CHW needs to perform essential services.
- Role-Specific Modules: Optional modules tailored to service- or population-specific responsibilities in a given context.
Who Can Benefit
The primary audience for this guide includes CHW educators and curriculum developers. Secondary audiences include regulators, accreditation agencies, CHW managers and supervisors, health service managers, and development partners supporting primary health care programs. The guide is adaptable to different countries, health systems, and program contexts, ensuring relevance and practicality.
Moving Towards Stronger Health Systems
A standardized, competency-based CHW curriculum equips workers with the tools, knowledge, and confidence to deliver high-quality care at the community level. By investing in CHWs’ education, countries can strengthen primary health care, improve equity, and accelerate progress toward universal health coverage.
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