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Prioritising the role of community health workers in the COVID-19 response
  1. Madeleine Ballard1,2,
  2. Emily Bancroft3,
  3. Josh Nesbit4,
  4. Ari Johnson5,6,
  5. Isaac Holeman4,7,
  6. Jennifer Foth8,
  7. Debbie Rogers9,
  8. Jane Yang5,
  9. James Nardella10,
  10. Helen Olsen4,
  11. Mallika Raghavan10,
  12. Raj Panjabi10,11,
  13. Rebecca Alban3,
  14. Serah Malaba8,
  15. Molly Christiansen8,
  16. Stephanie Rapp5,
  17. Jennifer Schechter12,
  18. Patrick Aylward12,
  19. Ash Rogers13,
  20. Jacques Sebisaho14,
  21. Clarise Ako14,
  22. Nandini Choudhury2,15,
  23. Carey Westgate1,
  24. Julius Mbeya13,
  25. Ryan Schwarz11,15,
  26. Matthew H Bonds16,17,
  27. Rehan Adamjee18,
  28. Julia Bishop19,
  29. Amanda Yembrick4,
  30. David Flood20,21,
  31. Meg McLaughlin22,
  32. Daniel Palazuelos11,23
  1. 1Community Health Impact Coalition, New York, New York, USA
  2. 2Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  3. 3VillageReach, Seattle, Washington, USA
  4. 4Medic Mobile, San Francisco, California, USA
  5. 5Muso, Bamako, Mali
  6. 6Global Health Sciences, University of California San Francisco, San Francisco, California, USA
  7. 7Department of Global Health, University of Washington, Seattle, Washington, USA
  8. 8Living Goods, Nairobi, Kenya
  9., Johannesburg, South Africa
  10. 10Last Mile Health, Monrovia, Liberia
  11. 11Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  12. 12Integrate Health, Lome, Togo
  13. 13Lwala Community Alliance, Rongo, Kenya
  14. 14Amani Global Works, Idjwi Island, Congo
  15. 15POSSIBLE, New York, New York, USA
  16. 16Harvard Medical School Department of Global Health and Social Medicine, Blavatnik Institute, Boston, Massachusetts, USA
  17. 17PIVOT, Ranomafana, Madagascar
  18. 18VITAL Pakistan, Karachi, Pakistan
  19. 19One to One Africa, Cape Town, South Africa
  20. 20Wuqu' Kawoq, Santiago Sacatepéquez, Sacatepéquez, Guatemala
  21. 21Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
  22. 22THINKMD, Burlington, Vermont, USA
  23. 23Partners In Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Madeleine Ballard; madeleine.ballard{at}


COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targeted actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.

  • health systems
  • health policy
  • public health

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  • Twitter @drmballard, @esbancroft, @joshnesbit, @isaacholeman, @ashlaurenrogers

  • Contributors EB and MB conceptualised the project. MB drafted the work. All authors made substantial contributions to the drafting of the work, contributing various sections and revising it critically for important intellectual content. All authors gave final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.