Digitalizing community health workers: learnings on the drivers of impact from a narrative review of digital health programs
1
Health Policy and Systems, University of Cape Town School of Public Health, Cape Town, South Africa
2
Global Health, York University, Toronto, Canada
3
International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
Popul. Med. 2026;8(Supplement Supplement 1):A951
ABSTRACT
INTRODUCTION:
Community health workers (CHWs) are central to primary health care delivery in low- and middle-income countries (LMICs), yet program effectiveness varies widely. Digital health interventions have been introduced to strengthen CHW performance, improve service delivery, and enhance health system integration. However, evidence on how and under what conditions digitalization produces impact remains fragmented. This review synthesizes evidence on digital health interventions targeting CHWs in LMICs to identify key drivers, mechanisms, and contextual factors influencing service delivery, care-seeking, health outcomes, and CHW performance.
METHODS:
This narrative review builds on a prior systematic review of digital health interventions for reproductive, maternal, newborn, and child health (RMNCH). Twelve high-quality CHW-focused digital health programs implemented across eight LMICs were identified. Targeted searches yielded 59 additional publications linked to these programs, resulting in 16 randomized controlled trials, cluster randomized trials, or quasi-experimental studies. Data were extracted on CHW program context, digital intervention design, health system integration, digital access and use, and outcomes. Evidence was synthesized thematically to examine pathways through which digital interventions influenced impact.
RESULTS:
Evidence from 12 programs across Asia and Africa indicates that digitalization can improve CHW performance, service delivery quality, and selected health behaviors. However, effects were inconsistent and highly context-dependent. Variation in CHW program design, digital tool functionality, and implementation support limited comparability across studies. Persistent challenges related to system integration, sustainability, and inequities in digital access were common and constrained observed impact.
CONCLUSIONS:
Digital health interventions can strengthen CHW performance and selected RMNCH outcomes, but impact depends heavily on foundational program design, integration with health system processes, and sustained support. Digitalization should be understood as a process of health system strengthening rather than a standalone technical solution.
Community health workers (CHWs) are central to primary health care delivery in low- and middle-income countries (LMICs), yet program effectiveness varies widely. Digital health interventions have been introduced to strengthen CHW performance, improve service delivery, and enhance health system integration. However, evidence on how and under what conditions digitalization produces impact remains fragmented. This review synthesizes evidence on digital health interventions targeting CHWs in LMICs to identify key drivers, mechanisms, and contextual factors influencing service delivery, care-seeking, health outcomes, and CHW performance.
METHODS:
This narrative review builds on a prior systematic review of digital health interventions for reproductive, maternal, newborn, and child health (RMNCH). Twelve high-quality CHW-focused digital health programs implemented across eight LMICs were identified. Targeted searches yielded 59 additional publications linked to these programs, resulting in 16 randomized controlled trials, cluster randomized trials, or quasi-experimental studies. Data were extracted on CHW program context, digital intervention design, health system integration, digital access and use, and outcomes. Evidence was synthesized thematically to examine pathways through which digital interventions influenced impact.
RESULTS:
Evidence from 12 programs across Asia and Africa indicates that digitalization can improve CHW performance, service delivery quality, and selected health behaviors. However, effects were inconsistent and highly context-dependent. Variation in CHW program design, digital tool functionality, and implementation support limited comparability across studies. Persistent challenges related to system integration, sustainability, and inequities in digital access were common and constrained observed impact.
CONCLUSIONS:
Digital health interventions can strengthen CHW performance and selected RMNCH outcomes, but impact depends heavily on foundational program design, integration with health system processes, and sustained support. Digitalization should be understood as a process of health system strengthening rather than a standalone technical solution.
| eISSN: | 2654-1459 |
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