The natural helper model: improving

The natural helper model: improving the selection of
community health workers
The natural helper model (NHM) is based on a simple
premise: within every community, an informal helping
network already exists. People with problems naturally
seek out other people they trust, and interactions are
often spontaneous [31]. The NHM taps into and uses
this already existing network to disseminate accurate
information on health and other social services to the
community; since many people are linked to different
helping networks simultaneously [32], the dissemination
of health messages can be reinforced. According to the
NHM, in order to recruit the most suitable candidates
for volunteering in the community, all community members’
networks of informal social support should be
studied. In this way, the most trusted and motivated
helpers, referred to as “natural helpers”, can be identified
[33-35]. Natural helpers are then trained to help others
more effectively, with the aim of ensuring that a trained
natural helper can act as a representative for each of the
networks within a community.
Studies conducted between 1945 and 1959 among ethnic
communities in South Africa uncovered the structure and
function of community helping systems and drew attention
to the significance of social networks in community health
education [36]. The NHM originated out of these insights
and was designed to enhance the ability of individuals to
help others through their own existing personal social
networks [37,38]. The NHM promotes the utilization of
“key persons” within social networks, individuals to
whom others “naturally turn for advice emotional support
and tangible aid” [39,40]. These persons are respected and
trusted, and have a reputation for being good listeners,
responsive to the needs of others, and in control of their
own life circumstances [41,42]. Utilizing existing community
structures increases both the short- and long-term
viability of health programmes and their ability to address
community needs [38]. While the NHM has been critiqued
for its long and rigorous process in identifying
natural helpers, others have argued that, for programmes
where sustainability is a priority, the trade-off in time and
resources during the identification process for natural
helpers becomes worthwhile [38,41].
In some instances, natural helpers have been referred
to as “lay health advisers”, especially in programmes in
the United States focused on minority communities [5].
While lay health advisers are paid workers, natural
helpers are not working for any agency but contribute to