In the late 1970's, David Werner (author of the classic CHW training manual Where There Is No Doctor) proposed that CHW program architects should consider whether CHWs were becoming lackeys for the health system (i.e. they were only working on specific tasks assigned to them, and not allowed to go beyond that role), or whether they were positioned to be liberators (i.e. they would work to be agents in the creation of their own destinies, and fundamentally address the social determinants that were making their communities sick).
Is being a lackey bad, especially if it reduces mortality?
Is being a liberator even possible? What does that look like?
Are these two the only options?
Link leads to: http://www.healthwrights.org/content/articles/lackey_or_liberator.htm