|Topic||Summary of findings|
|Evidence that CHWs are cost-effective||
• CHWs in LMICs are cost effective when compared to standard care for tuberculosis; weaker evidence of cost effectiveness is present for other areas (malaria programs and reproductive, maternal, newborn, and child health) .|
• Task shifting to CHWs from higher-level staff for HIV care in LMICs is cost effective [50, 52, 53].
• There is a cost savings of 24% when CHWs collect data using personal digital assistants compared to when they use traditional manual methods of data collection and transmission .
• Women’s groups (which were almost always facilitated by CHWs) practicing participatory learning and action to improve maternal and newborn health in LMICs were cost-effective as defined by WHO standards .
• Pediatric asthma care in HICs by CHWs may be cost-effective [56, 57].
• Diabetes care in HICs by CHWs could save US$2000 annually per Medicaid participant (according to one study) ; yield a return on investment of $2.28 per dollar invested (one study) , and reduce inappropriate health care utilization .
• Community case management of malaria by CHWs using rapic diagnostic tests is cost-effective in areas with low-to-medium prevalence .
• Potential cost savings are present by using CHWs for mental, neurological, and substance-abuse disorders in LMICs .
|Some cost-effectiveness analyses found no evidence||
• The evidence regarding the cost effectiveness of vaccination promotion by CHWs in LMICs is inconclusive .|
• There are no studies of the cost effectiveness of CHWs for the support of HIC populations with vascular disease .
• There are insufficient data to assess the cost-effectiveness of CHWs in the USA underserved groups compared to other types of community health interventions .