Impacts of community lay-leader health worker training & practice (Uttarakhand, India)

  • Nicole Butcher Nossal Institute of Global Health
  • Nathan Grills Nossal Institute of Global Health
Keywords: community health worker, training, India, primary healthcare, advocacy, health system strengthening


This study has investigated the impacts of the Community Lay-Leaders Health Training Certificate course on trainees and their communities, specific to the state of Uttarakhand, north India. A suite of semi-structured interviews and focus group discussions were conducted among course stakeholders and graduates respectively, and textual data was added to the data set. Thematic analysis of the results revealed four themes, including: (1) the effectiveness of course design and delivery, together with the key role of the Coordinating Facilitator; (2) the match between graduates’ practices, the providing institution’s objectives and general expectations of community health worker; (3) the strengthening of the health system through skills multiplication, collaboration with existing authorities, and advocacy for higher quality in professional practice; and (4) the need for ongoing support and training post-graduation. The findings are consistent with literature concerning community health workers’ roles and challenges, although some potentially unique outcomes were noted with respect to the pastoral support provided to trainees and the pro-active transfer of graduates’ knowledge and skills to fellow villagers.

Author Biographies

Nicole Butcher, Nossal Institute of Global Health

Based in Cambodia for nearly six years, Nicole worked as an independent public health consultant to various local, international and inter-governmental organisations. Originally from Melbourne, she passionate about building relationships across cultures and learning foreign languages. 
She has worked across the topics of family planning, maternal, newborn and child health, nutrition and food safety, HIV/AIDS, tuberculosis, ageing and oral health, for both general and marginalised/at-risk population groups. Her current focus areas are community health, disability and mental health in India.

Nathan Grills, Nossal Institute of Global Health
Associate Professor Nathan Grills, a Public Health Physician and NHMRC post doctoral fellow, works largely in India on disability, non-communicable diseases and health curriculum development and training. He has worked as a Public Health Fellow (Dept. of Health) and with CDC & WHO on HIV and civil society partnerships after completing his MPH and DPhil at Oxford University. He has international experience in Africa, Fiji, East Timor, PNG, Bangladesh and Nepal.He has faculty positions with Melbourne University (, the Public Health Foundation of India (, the Emmanuel Health Association (India) ( and is the international coordinator for the Community Health Global Network (


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How to Cite
Butcher, N., & Grills, N. (2017). Impacts of community lay-leader health worker training & practice (Uttarakhand, India). Christian Journal for Global Health, 4(2), 43-52.