Community health workers in Belgium

Despite the fact that Belgium implemented various reforms to make Primary Health Care (PHC) more affordable and accessible, inequalities in access to care are still increasing. The COVID-19 pandemic has additionally exacerbated the access to care challenges for people living in socio-economic vulnerable circumstances in Belgium. In order to achieve Sustainable Development Goal 3 (Good health and well-being for all), a healthcare system innovation is clearly needed. The COVID-19 pandemic provided impetus for introducing community health workers (CHWs) throughout Belgium at the start of 2021 - instigated by the Belgian Federal Government and executed by Intermut. The CHWs are, however, not fully integrated in the healthcare system. This presentation will provide an overview of the current state of CHWs in Belgium. To explore the potential of integrating CHWs in the Belgian health system, the research team is designing a new CHW-model. Since the country is also confronted with increasing health demands and limited budgets, there is impetus to tap into the potential of innovations from low and middle-income countries (LMICs). A review of health innovations in LIMCs and a theoretical analysis on the required characteristics of such a new model resulted in a CHW intervention - inspired by the Family Health System in Brazil and Re-engineering PHC in South Africa. The CHWs play a central part in both countries’ innovative health models which use designated health teams - consisting of one physician, one nurse, one nurse aide, and from four to twelve full-time CHWs. Each team interacts with all households in a geographically defined community. The team is the first entry point into the healthcare system and provides a wide range of primary care services to all individuals in a household over the life course in a pro-active manner. In this presentation we will show, how we can learn from innovation CHW-models in LMICs to address access to healthcare challenges in Belgium.