13. Learning from Worldwide Community Health Worker Programs: Exploring Their Potential for Integrated Care in Belgium

Community health workers (CHWs) support people living in socio-economically vulnerable situations to navigate the health system. CHWs are trusted members of local communities, who share the lived experience of the people they support. Inspired by examples of CHW programs worldwide, the Belgian Federal government gave the National Institute for Sickness and Disability Insurance and the National InterMutualist College the task to develop the first nationwide CHW program to improve access to care. This chapter provides insights into the Belgian Federal CHW program within the global CHW landscape. Community health workers play an important and unique but complex role situated between the health system and the community. We argue that CHWs have the potential to support a shift from vertical and disease-oriented services for people living in socio-economically vulnerable circumstances—which results in fragmentation that fosters duplication of services, weak coordination between levels of care and the inefficient use of human and financial resources—to a more horizontal and integrated approach. In exploring the potential of CHWs in integrated care, it is important to ensure that their “community-based identity” is safeguarded so that they can support people on the basis of mutual understanding and trust.