Community Health Workers & Promotoras: An Introduction
During the Industrial Revolution various initiatives were developed to bring health into the community. In 1859 William Rathbone used nurses accompanied by “lady visitors” to go into the homes of Liverpool; this became the model for British district nurses. In 1862 the Ladies Section of the Manchester and Salford Sanitary Association used a “working class woman” to visit homes and provide educational materials and sanitary advice; this program led to the adoption of home visits as a way to promote health.
Contemporary Community Health Workers fulfill a number of roles in health care systems. There is, however, a debate regarding the degree to which CHW should be “professionals” or remain lay workers. In 1999 Texas became the first state to offer a certification program for CHW, recognition of the important role that promotoras play in health care in immigrant communities; they are essentially the modern version of the Manchester “working class woman.” For current information on training of CHW, visit the Community Health Worker National Education Collaborative.
Perhaps the most comprehensive current site on CHW is the Community Health Worker Program Resource from the South Texas Health Research Center and the University of Texas Health Sciences Center at San Antonio. This site has information on training and certification, technical assistance, examples of CHW projects in the US, a bibliography, and a discussion of contemporary issues relating to CHW.
Community Health Workers and Community Voices: Promoting Good Health, is a 64-page document (PDF) that provides an overview of Community Health Workers. It was produced by the Community Voices initiative of the National Center for Primary Care at Morehouse School of Medicine. Their publications page has other documents on CHW.
Health Wrights has made available for free a number of books regarding community health and CHW on its website. Among these are the incomparable Where There Is No Doctor.
Latino Health Access works in Orange County, California to promote community health using promotoras (community health workers) and principles of community diagnosis. Watch a video of their work.
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