Abstract:
BACKGROUND: In low-to-middle income countries (LMICs), there is a growing burden of
non-communicable diseases (NCDs) placing strain on the facilities and human resources of healthcare
systems. Prevention strategies that include lifestyle behavior counseling have become increasingly
important. We propose a potential solution to the growing burden of NCDs through an expansion
of the role for community health workers (CHWs) in prescribing and promoting physical activity
in public health settings. This discussion paper provides a theoretical model for task-shifting of
assessment, screening, counseling, and prescription of physical activity to CHWs. Five proposed
tasks are presented within a larger model of service delivery and provide a platform for a structured,
standardized, physical activity prevention strategy aimed at NCDs using CHWs as an integral part
of reducing the burden of NCDs in LMICs. However, for effective implementation as part of national
NCD plans, it is essential that CHWs received standardized, ongoing training and supervision
on physical activity and other lifestyle behaviors to optimally impact community health in low
resource settings.
