Supporting Denver

Project summary

Promotoras help their community heal.

Promotoras have been an essential part of the healthcare system in South America since the 1950s. The term “promotora” comes from the Spanish word “promover,” which means “to promote,” and refers to Community Health Workers (CHWs), individuals who promote health and wellness in their communities.

Modern Community Health Workers (the way we understand them today) have been an integral part of healthcare systems for many years. The earliest knowledge of the Promotora system comes from observations in Latin America, Africa, Asia, and the Middle East as early as the 1920s. The origins of the modern CHW can be traced back to the late 1920s in South Africa, where malaria assistants were trained by senior health officers. Similarly, in China during the 1930s, “Farmer Scholars” were trained to address health concerns in their communities. These early efforts paved the way for the emergence of Barefoot Doctors, who were Chinese agricultural laborers engaging their fellow community members in taking responsibility for their health.

The emergence and proliferation of the Promotora system in Latin America can be traced back to the 1950s. During the same time, from the 1950s to the 1970s, the number of active Barefoot Doctors in China surpassed one million, highlighting the need to address the health needs of rural and underserved populations in developing countries. Inspired by the Barefoot Doctor approach, many countries, including Honduras, India, Indonesia, Tanzania, and Venezuela, implemented CHW programs to improve access to healthcare. The United States government also recognized the potential of CHWs and supported their programs as a means to expand healthcare access in underserved communities, leading to the development of community health centers.

In the 1970s and 1980s, CHW programs gained even more momentum all over the world, particularly in Latin America and Africa. Governments in countries such as Indonesia, India, Nepal, Tanzania, Zimbabwe, Malawi, Mozambique, Nicaragua, and Honduras launched national CHW programs. Non-governmental organizations (NGOs) also played a significant role in establishing smaller CHW programs in developed nations worldwide. These initiatives focused on promoting literacy, family planning, immunizations, and other economic development activities.

By that point in time, this promotora model had been around in Latin American countries for almost 20 years, but it didn’t really catch on in the United States until then. In the early 80s, the US government realized the importance of reaching out to rural, marginalized, and hard-to-reach communities to improve access to healthcare. Because of this new insight, the US started supporting campaigns to make this happen. In the 1990s, the Centers for Disease Control and Health Resources and Services Administration also played a big role in bringing attention back to the promotora model.