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Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature
  1. James O’Donovan1,
  2. Charles O’Donovan2,
  3. Isla Kuhn3,
  4. Sonia Ehrlich Sachs4,
  5. Niall Winters1
  1. 1 Department of Education, University of Oxford, Oxford, UK
  2. 2 Faculty of Medicine and Health, University of Leeds, Leeds, UK
  3. 3 Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
  4. 4 Earth Institute, Columbia University, New York City, New York, USA
  1. Correspondence to Dr James O’Donovan; james.odonovan{at}


Objectives Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs.

Design Systematic scoping review.

Data sources MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC.

Study selection Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies.

Results The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8).

Conclusions This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective.

  • global health
  • Community Health Worker (CHW)
  • lay health worker
  • education
  • on-going training
  • refresher training
  • in-service training
  • supportive supervision
  • low- and middle-income country (LMIC)

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors Activities undertaken by the authors were as follows: establishment of research question(s) and development of search strategy: JO, IK and NW. Background framing: JO and NW. Database search and record screening: JO, CO and IK. Extraction of primary studies from the included reviews: JO and CO. Discussion: JO, CO, NW and SES.

  • Funding JO is a DPhil candidate at The University of Oxford and is supported by a personal expenses and research support grant from the Economic and Social Research Council (ES/P000649/1).

  • Competing interests JO reports grants and personal fees from the Economic and Social Research Council during the conduct of the study.

  • Patient consent Not required.

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

  • Data sharing statement All data are contained within the main body of the text and in the online supplementary material.

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