The Work of Community Health Workers in Major Cities in Brazil Mediation, Community Action, and Health Care

This paper examines the role of community health workers (CHWs) and discusses the challenges in performing their multiple functions as: mediators linking the community and health services, community organizers, and care providers. A survey of CHWs was conducted in four towns in Brazil. The results indicate that during their home visits and community actions, the CHW perform educational and care activities for priority groups. Some CHWs work in health centers, where their functions include care management for chronic patients. The results indicate gaps in the work actually done, mainly as regards the expectation that CHWs would play a more political role, mediating between the communities and public policies, especially health policy. The CHWs in Brazil are general-purpose health personnel with a hybrid role that oscillates from technical to political profile.