TY - JOUR T1 - Community Health Workers in Pandemics: Evidence and Investment Implications JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-21-00648 VL - 10 IS - 2 SP - e2100648 AU - Madeleine Ballard AU - Ari Johnson AU - Iris Mwanza AU - Hope Ngwira AU - Jennifer Schechter AU - Margaret Odera AU - Dickson Nansima Mbewe AU - Roseline Moenga AU - Prossy Muyingo AU - Ramatulai Jalloh AU - John Wabwire AU - Angela Gichaga AU - Nandini Choudhury AU - Duncan Maru AU - Pauline Keronyai AU - Carey Westgate AU - Sabitri Sapkota AU - Helen Elizabeth Olsen AU - Kyle Muther AU - Stephanie Rapp AU - Mallika Raghavan AU - Kim Lipman-White AU - Matthew French AU - Harriet Napier AU - Lyudmila Nepomnyashchiy Y1 - 2022/04/28 UR - http://www.ghspjournal.org/content/10/2/e2100648.abstract N2 - Key MessagesA strong and accessible national health system, including at the community level, is critical for pandemic preparedness and response.Community health workers who are equipped, trained, and paid as part of a well-functioning health system can help prevent epidemics from becoming pandemics and maintain health care delivery amid significant disruption.To achieve resilient health systems, bi/multilateral aid and private philanthropies need to review their investment practices to replace those that cause harm (high transaction costs, earmarking, short-termism, appropriation of sovereignty) with practices that ensure timely and effective implementation of priorities set by government stakeholders (pooling, longer commitments, and alignment with evidence-based guidelines)Community health workers (CHWs)—people trained to meet the health needs of their communities by delivering care in their communities—have been a critical part of health care delivery across diverse contexts for over a century.1 They have also been woefully under-supported: recent estimates suggest that across the African continent, more than 4 in 5 CHWs are unpaid.2 In the context of increasing global health insecurity and a burgeoning health workforce crisis, this trend must change. The coronavirus disease (COVID-19) pandemic reminds us that CHWs who are equipped, trained, and paid as part of a well-functioning health system can help keep pandemics in check and maintain health services equity and access.True pandemic preparedness and response requires replacing bi/multilateral aid and private philanthropic investments that hinder CHW institutionalization and professionalization (high transaction costs, earmarking, short-termism, appropriation of sovereignty) with investments made in partnership with a recipient country. In particular, these funds should be deployed rapidly and flexibly against government-set priorities.In this commentary, we review the critical roles of CHWs during pandemics and discuss how rethinking common bi/multilateral aid and private philanthropic investment practices can help create resilient health systems everywhere.CHWs—if equipped with ongoing training, supervision, remuneration, … ER -