ORIGINAL PAPER Profiles, Perceptions and Motivations of Community Health Workers of NGOs in a Border City of US-Mexico Beatriz Alfaro-Trujillo • Ana M. Valles-Medina • Adriana C. Vargas-Ojeda Published online: 29 September 2011 Ó Springer Science+Business Media, LLC 2011 Abstract To analyze the profile, perceptions and moti- vations of Community Health Workers (CHWs) from non- governmental organizations (NGOs) in the border city of US-Mexico and to describe the type of community inter- ventions they perform. we surveyed 121 CHWs from 9 NGOs participating in a monthly meeting between May and July of 2009. Each participating CHW answered a structured questionnaire. Furthermore, two focus groups were held, in which 10 and 8 CHWs participated, respec- tively. Qualitative and quantitative analyses were carried out on the data obtained. 70% of the CHWs had 9 years or less of formal education. With respect to community work, 61% volunteered between 1 and 5 h weekly; only 40% received some form of economic support. The most com- monly reported activities were distribution of informational materials (59.5%) and promotion of health fairs (52.9%). Analysis of focus group discussions lead to the develop- ment of four conceptual categories: personal development, motivation, perception of their community participation and institutional relationship, some of the testimonies are ‘‘…just because the people do not respond does not mean we give up. No, we must work, persist, promote and raise awareness of the people…’’, ‘‘…when they compensate us, it is not really a payment. We are there because we get results, we do it happily… It is voluntary…’’ CHWs are an important human resource for communities. Institutions focusing on primary care should view these community players as social capital, which could improve the effectiveness of prevention strategies and achieve greater coverage of health services. Keywords Community health workers Á Health promotion Á Community health services Á Community health education Á Promotoras Introduction Historically, the role of the community health worker (CHW) has been to provide basic health services such as vaccinations or treatment of minor illnesses among popu- lations who lack guaranteed medical attention [1]. CHWs emerged as a social entity in the 1960s in many countries as a community outreach strategy, and as a response to the difficulties health systems had in reaching marginalized communities [2]. The function of CHWs has not only been to provide medical attention to poor communities, but also to act as agents of social change, who help improve the unequal distribution of health resources and defend the rights of their communities [3, 4]. Interest in CHWs programs in developing countries became relevant in the 1990s in light of the Acquired Immunodeficiency Syndrome (AIDS) epidemic [3, 5], the resurgence of other infectious diseases and the inability of formal healthcare systems to provide adequate attention to people suffering from chronic diseases. Similarly, the growing emphasis on decentralization and collaboration with existing community organizations influenced the growing interest in CHWs, that has developed in the absence of compelling interest regarding its effects [1, 6, 7]. Some authors place particular emphasis on the CHWs are not the best solution to cover all the needs of the dif- ferent healthcare systems, since one must consider the B. Alfaro-Trujillo Á A. M. Valles-Medina (&) Á A. C. Vargas-Ojeda Division of Public Health, Universidad Autonoma de Baja California, School of Medicine and Psychology, Apdo. Postal # 113-A, Mesa de Otay, CP 22350 Tijuana, B.C., Mexico e-mail: avalles@uabc.edu.mx 123 J Community Health (2012) 37:583–590 DOI 10.1007/s10900-011-9486-z