This review examines the use of various categories of Community Health Workers (CHWs) as first line health workers in dealing, for example, with maternal and child health, tuberculosis, HIV/AIDS, malaria and other issues throughout Africa. It attempts to address key questions such as: What has happened to Community Health Worker programs over the past two decades in Africa? What models are being used? What type of work do CHWs undertake? In which countries is work being undertaken? How are programs structured and managed? What kind of training are CHWs given? How effective are CHWs? What problems, challenges and obstacles have they faced?  Case studies have been included to illustrate success stories and experiences. These provide vivid insight into the types of CHW models being used, the relevance of CHWs, their recruitment, training, and roles. They illuminate issues related to their supervision and accountability, and types of incentives or remuneration offered and how these are impacting on sustainability, tenure of service and career path, obstacles, problems and challenges encountered. 

Uta Lehmann, Irwin Friedman/ 2004