Community health workers go by many different names around the world. Sometimes they are paid, and sometimes they are volunteers. They are often women, working to improve maternal and child health in developing countries. In wealthier nations such as Canada, such workers are important in improving access to formal health systems and in providing health-promoting services for marginalized groups. Community health workers are often described as the ‘backbone’ of comprehensive primary health care. As important as they are, we still need to know more about how they might be integrated within formal health systems such that they can effectively bridge between such systems and the many communities they serve.