Neglected tropical diseases (NTDs) are a collection of more than twenty infections caused by parasites, bacteria, and viruses, collectively affecting over a billion people worldwide. Community Health Workers (CHWs) are increasingly recognized as vital for expanding access to NTD prevention and treatment in low- and middle-income countries (LMICs), yet the economic evidence supporting their deployment remains scarce. To map existing knowledge, a scoping review was performed, examining studies published between August 2015 and July 2024 across ten academic databases and grey literature sources. Searches focused on CHWs and economic evaluation metrics, with study selection guided by predefined inclusion and exclusion criteria. Data on methodology, costs, and outcomes were systematically extracted and analyzed using Microsoft Excel. From 10 studies, 29 implementation scenarios were identified. Seven scenarios involved mass drug administration at the community level, while the remaining 22 explored other interventions, including disease-specific preventive and treatment programs such as dengue control. Economic outcomes most frequently reported included cost per capita (ranging from $10.24 to $21.09) and cost per service delivered (ranging from $0.13 to $5.33). Cost-effectiveness was assessed in five scenarios, yielding mixed results, with roughly 40–50% of interventions considered cost-effective. Notably, one study found that programs integrating multiple services were more likely to be cost-effective than those following vertical, single-disease approaches. Despite these findings, the evidence base remains limited, and no definitive conclusions can be drawn regarding the affordability or overall cost-effectiveness of CHW-led NTD interventions in LMICs. Additional rigorous economic evaluations are needed to better understand how CHWs can contribute to both preventive and treatment-focused NTD strategies.
