Key messages

- The use of lay health workers in maternal and child health programmes shows promising benefits compared to usual care or no intervention in:

− increasing the uptake of immunization in children;
− promoting breastfeeding;
− reducing mortality in children under five years;
− reducing morbidity from common childhood illnesses.

- Little evidence is available regarding the effectiveness of substituting health professionals for lay health workers or the effectiveness of alternative strategies for training, supporting and sustaining lay health workers.
- Factors that need to be considered to assess whether the intervention effects are likely to be transferable to other settings include:

− financial support for lay health worker programmes;
− the availability of routine data on who might benefit from the intervention (e.g.children whose immunization is not up-to-date);
− resources to provide clinical and managerial support for lay health workers;
− the availability of drugs.