Community health worker (CHW) incentives and remuneration are core issues affecting the performance of CHWs and health programs. There is limited documentation on the implementation details of CHW financial compensation schemes used in sub-Saharan African countries, including their mechanisms of delivery and effectiveness. This study documents CHW financial compensation schemes in Benin, Burkina Faso, Ghana, Malawi, Mali, Niger, and Zambia to understand CHW, government, and other stakeholder perceptions of their effectiveness.
Policymakers should consider these findings in the design of compensation schemes for CHWs engaged in routine, continuous health service delivery within the context of their country’s health service delivery model. Greater sensitization of the 2018 World Health Organization recommendation on CHW compensation, along with practical guidance on how to assess CHW responsibilities, workload, and training, may be needed to support the practical application of this global normative guidance at the country level.