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Difference between a nurse and a community health worker (CHEW)

Difference between nurse and Chew….Difference between a nurse and a community health worker (CHEW).

The kind of discrimination community health extension workers (CHEWs) face in Nigeria is alarming….let me make it clear to you, constitutionally, CHEWs are part and parcel of the health care workers/system. Most of the primary health care centres in rural areas are run by CHEWs.

Are you still in question about the differences between these 3 categories of health cadre???

1-Medical practitioner/Doctor/Physician


3-Community health practitioner/ Community health extension workers (CHEWs)

1-They are all part of the health team, in which everyone of them practice according to his level of training, competence and as stipulated by law.

2-In Every setting/Hospital Doctors are the most senior cadre in health care provision.

3-Community health practitioners are the most senior cadre in Primary health care centres where there is no other trained medical practitioner (according to Nigerian health Act of 2014).

Difference between nurse and CHEW…CHO in the the community

4-Nurses in Hospital setting work hand in hand with the doctors and other clinical staff to cater for the patient health needs.

5-The Community health practitioners (CHP) are bound to work with a standard operating procedure for primary health care workers (known as STANDING ORDER). It is illegal for a CHP to practice without it.

6-Every one of these cadres can work independently or under the supervision of the senior cadre. Globally, medical doctors still largely call the shots and their written treatment plan must be followed by the nurses and younger doctors….This does not mean nurses, chews and others are subservient to doctors….they are allowed to disagree professionally on treatment plan and protocols.

7-You’re fully responsible and answerable for all your action regarding your action/care given to any patient at any place.



1. Doctors are basically trained to provide health care needed by the community at all level -primary,secondary, and tertiary. And to be able to train other health care professionals.

2. Nurses are also created to assist/ provide in the health care needs to community at all level- primary, secondary, tertiary.

3. Community health practitioners-are specially trained personels to provide health care services at primary health centres and comprehensive health centres. There are also CHEWs in the teaching hospitals and federal medical centres (tertiary level).

Things to consider.

1-The basic of creation of all cadres are to provide universal and qualititave health access to all people regardless of where the reside.

2-the mode of training,curriculum and standard operating procedures are totally different.

3-Doctors are trained only in the medical college and the duration of training last 6-7 years.

4-Nurses are trained only in college of Nursing and the training last 3-5 years. There is now BSC nursing in some Nigerian Universities…a 5 year nursing program.

5-Community health practitioners are trained only in College of health technology where the training last 2-3 years.


At this point you have to at least understand that every professional is important as the other in health team,
from doctor to cleaners

No single category of health workers can provide effective health care to community alone without the help of the other cadres.



Lastly, you should stop comparing community health extension workers (CHEWS) to nurses and nurses to doctors. IT IS NOT ABOUT WHO IS MORE QUALIFIED BETWEEN A NURSE AND A CHEW OR COMMUNITY HEALTH OFFICER (CHO). THEY ALL HAVE THEIR ROLES.

Each one is created independently and for specific reason to meet the health need/demand of the community.


Babagida Rufai Wurno (SCHEW/CHP)

Nurse Gift Asemota

Dr Udomoh

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This post was last modified on February 9, 2022 1:01 am

Udomoh Eshemokha

I am a practicing medical doctor, a philosopher, critical thinker, a globalist, a patriot, SEO expert and a patient blogger.

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  • So does it mean that nothing can be done concerning the discrimination between the nurses and community health worker's?

    I am a community health worker and I can testify about this discrimination of a thing sometimes I regret why I studied cHEw because of how we are being treated in some hospitals especially private organization. Something should be done please 🙏

  • None of the cadre have the right to discriminate. Like what the writer said " it is not about who is better than the other" it is about who can provide better care to people. We're all in this health team. The Chews has their role to play likewise Nurses and Doctors. Without the help of one another the services we render e.g Care, Promotive, Preventive, Counselling, and Rehabilitative can't be done ..... Let's work hand in hand please, stop the discrimination let's focus on how to makes things better.

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Udomoh Eshemokha