Thousands of women die each year in Africa from complications of childbirth. Many aren't able to get to medical clinics for help (too far away, too costly, too difficult to travel, etc.). They perish for lack of medicines and lack of care. And so the idea is to bring at least some help to them. Community health workers are one way to get needed supplies and at least some primary health care to people living in rural areas.
How might this work? CHWs might be employed by provincial or national ministries of health, but a different model would to be create social enterprises designed to fill this niche. A social entrepreneur would train health care workers and send them to rural areas to meet local needs. Governments might contract with these private-sector providers to operate in a particular area, doing a particular set of tasks. Another model would be for villages savings and loan organizations, or local cooperatives, to contract with these health care providers. If the former model was adopted, governments would enter a public-private partnership to provide a social service; in the latter case, a private-sector alternative to public sector care would, no doubt, need to satisfy some accredidation or certification process and would be paid for directly by the people receiving the care.
The concern would be that the rural poor are not being treated by more educated, or better trained medical professionals. Of course though, they're oftentimes not being treated now, so the choice is not really between higher quality care and lesser quality care; it's between some care and no care. And some care is almost certainly better than none. One challenge in implementing such a program would be to create appropriate incentives for national ministries of health to give up some control over the provision of health care and allow for more entrepreneurship in this realm. But, allowing coops and other extant rural organizations to contract with private-sector providers for such services could be both a cost-effective and a life-saving health care alternative. (The photo is one of mine from an orphanage in Botswana).