Retsilake in Atsimo Andrefana, Madagascar, is one of the 6,000 high-performing community health volunteers (CHVs) supported by the USAID-funded ACCESS project

A community health system (CHS) is a set of local actors, relationships, and processes engaged in producing, advocating for, and supporting health in communities and households outside the formal health system.

Community stakeholders such as public health officials, local organizations, community health leaders, private sector providers, civil society, and frontline workers play a vital role in community health systems by identifying and addressing problems within their health care systems. When local stakeholders identify solutions, their ownership and accountability for the quality of their health system increases, and self-reliance is strengthened.

USAID’s programs enable participation from this spectrum of local stakeholders. In Malawi, we supported the country’s first National Community Health Strategy, which defines a new community health system in which community health cadres, both formal and non-formal, deliver Essential Health Package services, with a focus on child and maternal health. USAID and Malawi aim to build civil society and community engagement to ensure social accountability in health at the national level.

Civil society supports Ministries of Health to identify national priorities for community health systems. USAID is strengthening civil society engagement to support the realization of these priorities, such as in Liberia, where we support the government’s new national community health policy that formally recognizes the role of civil society, including communities, in planning, managing, and monitoring the quality of primary health care at the community level. Additionally, USAID is collaborating with Liberia’s Ministry of Health and other global partners for the 3rd International Community Health Worker Symposium 2023. The aim of the symposium is to facilitate the global exchange of knowledge and solutions to scale and sustain Community Health Programs in order to achieve Universal Health Coverage (UHC).

USAID also partners with UNICEF and other global health leaders for the Community Health Roadmap, a collaboration between traditional multilateral and bilateral donors, partners, governments, and private funders to advance national policy and systems priorities to achieve their goals for primary health care (PHC), universal health coverage (UHC), and Sustainable Development Goal (SDG) 3. The Roadmap works with Ministries of Health across multiple countries to identify community health national investment priorities that strengthen primary health care.

The below graphic depicts the participatory and oversight role community health systems play in primary health care in Malawi. Other community health roadmaps are available to view at


Primary Health Care Structure at Community Level | Click for Text Version


Click for text version


3rd International CHW Symposium 2023 – March 20-24, 2023

Community Health Roadmap

Community Health Worker Assessment and Improvement Matrix

Vision for Health System Strengthening 2030

Acting on the Call: Preventing Child and Maternal Deaths: A Focus on Sustaining Lifesaving Health Services Amidst the COVID-19 Pandemic