Community Health Worker Program Characteristics and Population Health Outcomes: A Scoping Review

Community health workers (CHWs) are crucial for strengthening primary health care and reaching underserved populations. However, variations in program implementation lead to differing outcomes. This scoping review maps evidence on CHWs program characteristics, supervision, technology use, service delivery approaches, and associated health outcomes across global contexts. A scoping review was conducted to examine the primary studies that focused on CHWs program characteristics and their relationship with population health outcomes. A systematic search was conducted across three major databases–Web of Science, Scopus, and CINAHL–guided by the framework of Arksey and O’Malley. After screening titles and abstracts, 103 full-text articles were assessed for eligibility, and 31 studies were included in the final analysis and synthesis. Thirty-one studies from sub-Saharan Africa (n = 18), North America (n = 10) and Asia (n = 3) were included. Six distinct supervision models were identified, with outcomes ranging from 7–9% visit completion under minimal supervision to 86% blood pressure control with real-time telehealth supervision. The training duration varied from 3 days to 100 h, with no consistent relationship between duration and effectiveness. Technology integration enhances CHW performance when combined with adequate supervision and training. Five service delivery models demonstrated differential effectiveness: home-based models achieved significant improvements in maternal-child health and chronic disease management; facility-integrated approaches showed the strongest evidence for high-utilization patients with multiple chronic conditions; hybrid telehealth models achieved superior outcomes (86% vs. 44% blood pressure control, p < 0.001) compared to facility-based care, community-based distribution expanded access in remote areas, and team-based integrated care improved quality of care and reduced hospitalizations by 65–69%. CHW program effectiveness depends critically on implementation quality rather than program presence alone. Enhanced supervision, competency-based training, strategic technology integration, appropriate service delivery model selection, and sustainable financing are essential for achieving positive health outcomes.