Best buys for Africa: Community Health Workers for tuberculosis control
A modelled strengthened CHW platform to support CHW-led TB case detection and adherence support translates in South-Africa to a high net benefit to cost ratio of 4.8. The largest contributor to the benefits stems from the value of the DALYs that have been averted through reduced deaths and reduced morbidity due to increased case-finding and cure rate. This analysis adopts a provider perspective and does not consider the broader savings to potential patients through averted infections. A crucial element in the success of CHW supported services is the standardization and adequacy of renumeration, as well as the strengthening of training and crucially supervision/support to ensure a high quality of service provision.