Community Health Worker Incentives and Disincentives: How They Affect Motivation, Retention, and Sustainability

This paper examines the experience with using various incentives to motivate and retain community health workers (CHWs) serving primarily as volunteers in child health and nutrition programs in developing countries. It makes recommendations for more systematic use of multiple incentives based on an understanding of the functions of different kinds of incentives and emphasizes the importance of the relationship between a CHW and community. Case studies from Afghanistan, El Salvador, Honduras, and Madagascar illustrate effective use of different incentives to retain CHWs and sustain CHW programs.