Table 3 Common elements of CHW programmes associated with pro-equity outcomes

Expanding CHWs’ remit

Bangladesh: CHWs providing skilled birth assistance and ANC resulted in increased ANC attendance (≥ 4 visits) and use of SBAs, with the greatest improvements in hard-to-reach locations [56].

Mozambique: CHWs promoting, diagnosing and treating childhood illnesses resulted in early care-seeking behaviour (within 24 h of onset) in lower SES groups [90].

Increased CHW training & mentoring

Ghana: Enhanced CHW training for assessment and referral of newborn illnesses and follow up with addressing barriers to compliance was associated with higher compliance with referrals and doubled independent care seeking for newborn illnesses in women in the poorest quintile [23].

Addressing financial barriers

India: Cash transfers to women for institutional delivery and to CHWs for conducting ANC led to an increase in ANC attendance and facility delivery 5–6 years later, with the largest increase among women of low SES and educational attainment [88].

Uganda: reducing cost outlay for CHW-provided services led to improvements in care-seeking for childhood illness among lower SES groups [91].

Promoting effective partnerships

Ethiopia: Effective collaboration between trained CHWs and unpaid volunteers led to increased use of SBAs and PNC, and decreased use of untrained providers or no provider, with the greatest improvements for women of lower SES [58].

Adapting to local contexts

Ethiopia: Use of locally appropriate channels for behaviour change communication (e.g. radio spots, mobile video drama) and adopting local solutions for pregnancy identification, registration, birth notification (+ extended service provision + ongoing training and mentoring) were associated with better care seeking for pregnancy complications, specifically in lower SES groups [89].

Nigeria: Development of more practical and user-oriented workshops were associated with greater likelihood of use of bed nets among people with lower levels of formal education [142].