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Volunteer community health workers (CHWs) are one approach to addressing the health workforce crisis in developing countries. BRAC, a large Bangladeshi NGO, a pioneer in this area, uses female volunteer CHWs as core workers in its health programs. After 25 years of implementing the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through its community-based mother, newborn and child health interventions. However, the program experienced suboptimal performance among CHWs, with a high percentage of them remaining in their positions but becoming “inactive”, not truly participating in daily community health activities. This suggests a need to better understand the relative importance of factors affecting their active participation and to recommend strategies for improving their participation.
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