2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

India is undergoing a marked epidemiological shift from a predominance of communicable diseases to a growing burden of non-communicable diseases (NCDs), which poses major challenges for health systems. To address the challenge of shortage in primary healthcare workers, and to lead comprehensive primary healthcare service provision at upgraded primary health centres (PHC) and sub-health centres (SHC) known as Ayushman Arogya Mandirs (AAMs), a mid-level healthcare worker known as Community Health Officers (CHOs) were introduced in 2018, who play a pivotal role in bridging the gap between communities and the health system by offering outpatient care, managing NCDs, and facilitating health promotion activities. The CHO being a relatively new cadre, institutionalization of the cadre is still in process, and presently there is limited systematic evidence on CHO’s performance, effectiveness and functional integration into primary healthcare systems. The study objective is to assess the CHO’s knowledge, skills related to clinical, managerial including public health functions, evaluate their performance in delivery of comprehensive primary healthcare, and explore factors influencing their motivation and challenges affecting their functioning. A cross-sectional mixed methods study design is adopted with quantitative and qualitative components, along with secondary data review.  As of 31st March 2026, there were 1,19,617 CHOs in position across total 166, 532 functional AAMs in the country. Out of total 119,617 CHOs,  total 74,987 (62%) had been trained in expanded package of services (Source: https://aam.mohfw.gov.in/home). The study seeks to generate empirical evidence on how effectively CHOs are delivering their mandated clinical, public health, and managerial functions, and how their performance contributes to the objectives of comprehensive primary healthcare, and result will inform evidence-based policy decisions to enhance the acceptability, effectiveness, and sustainability of the cadre.