Community health agent (agente comunitário de saúde or ACS, in Portuguese language) is the title of a specific lay health care worker developed in Brazil by way of PACS (Program of Community Health Workers) in 1991 as part of the construction of the Brazilian Unified Health System established by Constitutional rule in 1988.
The agent, which was said to be inspired on the barefoot doctors program in China, is not certified to practice medicine or nursing, but has the primary task of gathering information on the health status of a small community by means of a close relationship with it. In the initial design, the agent should be one of the residents of a street, neighborhood or surrounding region, and was to be selected on the basis of a good relationship with his neighbors, in addition to the ability to devote eight hours a day to the work. Every agent is supervised by a doctor or nurse of the health clinic, and home visits are conducted in the coverage area of a basic health unit, thus producing information that can assess the main health problems of his community.
With the proposition of the Brazilian Ministry of Health in 1994, when it created the a nationwide family health program, called PSF -- Programa de Saúde da Família—health community workers can be found in two different situations in relation to the health care system:
Currently (October 2009), there are more than 260,000 community health agents present both in rural and peri-urban areas of small municipalities as well as in highly urbanized and industrialized cities.