title: The work of community health workers in major cities in Brazil: mediation, community action, and health care.
abstract: 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.
authors.affiliation: National School of Public Health Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. marciafausto@ensp.fiocruz.br
authors.forename: Márcia Cristina Rodrigues
authors.initials: MC
authors.lastname: Fausto
authors.forename: Ligia
authors.initials: L
authors.lastname: Giovanella
authors.forename: Maria Helena Magalhães
authors.initials: MH
authors.lastname: de Mendonça
authors.forename: Patty Fidelis
authors.initials: PF
authors.lastname: de Almeida
authors.forename: Sarah
authors.initials: S
authors.lastname: Escorel
authors.forename: Carla Lourenço Tavares
authors.initials: CL
authors.lastname: de Andrade
authors.forename: Maria Inês Carsalade
authors.initials: MI
authors.lastname: Martins
mesh_terms: D000328:Adult; D001938:Brazil; D003150:Community Health Workers; D019058:Community Networks; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006792:House Calls; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011787:Quality of Health Care; D019037:Urban Health Services