Providing health care within communities is important, and perhaps nowhere more so than in the WHO Eastern Mediterranean Region. CHW programmes are especially important in the Region because there are high illiteracy rates, poor infrastructure in some areas, and especially tight-knit communities that in some cases may lack trust for higher networks such as governments and nongovernmental organizations (NGOs). Improving, scaling up or developing CHW programmes in the Region could have a significant impact on maternal and child health outcomes, as well as improve mental health and reduce infectious disease burden (1-6). Several countries within the Region have had significant success with CHW initiatives. The objectives of the study were to give an overview of the characteristics of three specific CHW programmes in Egypt, Pakistan and Afghanistan, and to review their strengths, weaknesses and challenges. Methods A literature search was conducted in PubMed, Medline and Cochrane Review Library. Grey literature including governmental programme evaluations and WHO documents were also searched. The search was conducted