将社区卫生工作者纳入卫生系统：分步政策实施指南

Integrating communityhealth workers into A step-by-step policy Integrating communityhealth workers into A step-by-step policy Integrating community health workers into health systems: a step-by-step policy implementation guide ISBN 978-92-4-011029-8 (electronic version)ISBN 978-92-4-011030-4 (print version) © World Health Organization 2025 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence(CC BY-NC-SA 3.0 IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the workis appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specificorganization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must licenseyour work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should addthe following disclaimer along with the suggested citation:“This translation was not created by the World Health Organization Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of theWorld Intellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules/). Suggested citation. Integrating community health workers into health systems: a step-by-step policy implementation guide.Geneva: World Health Organization; 2025. Licence:CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.CIP data are available athttps://iris.who.int/. Sales, rights and licensing.To purchase WHO publications, seehttps://www.who.int/publications/book-orders. Tosubmit requests for commercial use and queries on rights and licensing, seehttps://www.who.int/copyright. Third-party materials.If you wish to reuse material from this work that is attributed to a third party, such as tables, figuresor images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the General disclaimers.The designations employed and the presentation of the material in this publication do not imply theexpression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of itsauthorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommendedby WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the publishedmaterial is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation anduse of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Contents AcknowledgementsivAbbreviationsvExecutive summaryviIntroduction2Step 1 Assess the national context and state of CHW programmes4Step 2 Conduct a stakeholder analysis and engagement with actors involved in PHC and CHWprogrammes5Step 3 Determine the governance structure for CHW integration7Step 4 Define the vision, goals and timeframe of CHW integration8Step 5 Ensure sustainable financing of CHW integration9Step 6 Design the integrated CHW programmes106.1 Planning CHW scope of practice and needs quantification106.2 CHW selection, education and certification126.3 CHW management and deployment156.4 Support for CHWs from the health system and community18Step 7 Adapt CHW integration inthe context of emergencies207.1 Key questions – prevention, preparedness, response and recovery in emergencies207.2 Policy dialogue focus in emergencies21Step 8 Monitor and evaluate CHW integration22Conclusion24References25 List of figures Fig. 1 Action steps and policy decisions for integrating CHWs into health systems3Fig. 2 Broader social context for integration of community health workers into the health system4Fig. 3 Engage with stakeholders and determine a programme anchor5Fig. 4 Identifying stakeholders and understanding roles of government, partners, health workers andcommunities7Fig. 5 Align governance of CHW programmes with national health and CHW policies8Fig. 6 Key decisions, analysis and policy priorities to plan CHW scope of practice and quantify needs10Fig. 7 Key decisions, analysis and policy priorities for CHW selection, education and certification12Fig. 8 Key decisions, analysis and policy priorities for CHW management and deployment15 Acknowledgements WHO is grateful to the following individual experts forpeer reviewing the document: Ochiawunma Akwiwu-Ibe (independent public health and community healthsystems strengthening