Community health workers in Brazil and the global movement for universal health coverage

Universal health coverage is one of the greatest unfulfilled ambitions in global health. The proposed project explores the role played by community health workers (CHWs) in efforts to realise this elusive goal, focusing in particular on the case of Brazil. CHWs have been invoked amongst global policymakers as a unique mechanism for the improvement of health systems, enhancing equity by bringing services to those previously excluded while also enhancing democracy by mediating marginalised groups’ perspectives through to decision-making processes. In recent years, Brazil has provided a model that has been turned to by national and international policymakers to guide health system reform in middle-income and emerging states, and as such represents a case in need of further systematic study.

This political science-centred and historically-rooted project develops an innovative approach to this crucial, and largely overlooked, aspect of universal coverage. It draws on new archival material and extensive fieldwork in Brazil to explore the evolving role of CHWs from 1950 to the present day, generating insights into the patterns of success and failure surrounding their work. The project also investigates changing visual representations of CHWs through film and photography, shedding light on the assumptions and cultural meanings attached to their role.