When Health Centers and organizations are planning to start new Community Health Worker (known as Promotoras de Salud in Spanish-speaking communities) programs or expand existing ones, one of the first questions they ask is how CHWs should be compensated.

Compensation strategies continue to be debated among CHW advocates. Some argue that CHWs deserve to be paid fairly for their work, while others say that CHWs answer first to their own communities and that their allegiance may shift to the organization if they become employees. There is also concern that formalizing their role and standardizing their work may limit their ability to act autonomously and creatively in the best interest of their communities.

This document lays out three compensation strategies for Promotores de Salud: volunteer, contract and employee, each with its own case study, tips for success and possible pitfalls.

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