Participants in 2026 CHW training session.

Collaborations

Boston University/HENAR Expand Syunik Healthworker Program

The HENAR Foundation recently announced expansion of their Community Healthworker (CHW) Program in Syunik, the southernmost province of Armenia. What started with three villages in 2024 has expanded to four additional villages, thanks to funding from the John and Hasmik Mgrdichian Foundation. For the past year, primary medical care in these rural villages has been supported by community healthworkers with HENAR’s leadership and support. Most recently, HENAR has partnered with the Boston University-Armenia Medical Partnership (BU-AMP) on the CHW project, heralding an exciting new phase of collaborative effort. Plans to scale up the project to more villages in Syunik, to introduce new training approaches, and to raise community awareness are essential components of the new partnership.

Community healthworker programs are so important to delivering quality healthcare in underserved areas.

Aram Kalligian, MD, clinical associate professor of family medicine, and director of BU-AMP

CHWs are healthcare workers that directly represent the community they work in and provide basic medical and psycho-social services without the formal education required to be a professional healthcare provider. It’s a model that has been introduced and scaled all over the world, including in the U.S. It has had deep positive change in many settings and is an intervention that the World Health Organization considers a fundamental component of any good healthcare system. Costa Rica’s CHW system has been lauded as a main cause of the country’s exceptional health outcomes, in a region with mostly poor outcomes at higher cost.

“Community healthworker programs are so important to delivering quality healthcare in underserved areas,” says Aram Kaligian, MD, director of the BU-AMP, and clinical associate professor of family medicine. “Syunik is a full day’s drive from Yerevan, and most villagers there just do not have the same access to healthcare as other parts of Armenia. So often the barrier to good health outcomes is due to patients’ misunderstanding how to take their medications, what to do if they can’t get their prescriptions filled, or just being too far from health facilities.” Community healthworkers help explain what medications are for, how to take them correctly, and help troubleshoot any difficulties with access to medical care.

Currently the program functions in seven villages near the towns of Goris, Sissian and Tatev — all a full day’s journey from Yerevan — sitting close to the borders with Azerbaijan and Iran. The villagers in this region have seen conflict and trauma from generations of war and face a difficult situation given their isolation from the rest of the country. They often feel forgotten and disconnected from their doctors, clinics and hospitals.

CHWs work to fill these gaps and support those in need. HENAR started with focus groups, asking the community what were their health priorities and obstacles. They then found villagers to work alongside the existing village nurses and trained pairs (one CHW and one nurse) in each village to provide care, both physical and psychological. The program does not work to replace any part of the healthcare system in the region but works to complement it, connecting patients to their doctors, helping clarifying their medication lists, and supporting health screenings in places that the system cannot always reach. The groups started slowly, going door to door, introducing themselves as part of this new approach towards health. What was first seen with a bit of skepticism by the villagers is now an essential service. If a CHW takes even a few days off villagers are asking where they went and why they haven’t visited recently.

The program is one born from a collaborative group of healthcare professionals and volunteers, including diasporan physicians from the US. The program director, Dr. Henry Louis, has built CHW programs in countries across the region and introduced the concept to Syunik through the HENAR foundation’s initiative. “The CHWs that work in Syunik provide essential services to villagers that otherwise would not interact with the healthcare system,” says Louis. “Going to someone’s home and sitting with them in their living room, talking to them about their health and wellness, is therapeutic in and of itself. If we can get people to go to their doctors and take their meds, even better.”