Employing practitioner expertise in optimizing community healthcare systems.

To harness the potential of community health workers (CHWs) to extend health services to poor and marginalized populations and avoid the pitfalls of the post-Alma-Ata period, there is an urgent need to better understand how CHW programs can be optimized. Understanding that several operational questions are unresolved by current academic evidence, this viewpoint considers the role of practitioner expertise in optimizing community health systems and highlights findings from a recently published report that captures implementation experience from 15 countries. The viewpoint considers applications of the report's suggested community health design principles and implications for implementers, philanthropists, policymakers, and academic researchers.