This report is a synthesis of the final country reports produced by the four countries that participated in the 4-Country Community-based Worker Systems project. Chapter 1 explains the project’s rationale and process. Chapter 2 gives contextual background. Chapter 3 presents the case study reviews and findings on selection procedures, financing, training, roles and responsibilities, support and supervision, accountability, coordination and linkages to other stakeholders. Chapter 4 presents the pilot projects and chapter 5 findings as to impact and cost-effectiveness. Chapter 6 examines the implications for policy and legislation. In addition to this report, recommendations that emerged from the project have been captured in a set of Guidelines for practitioners for implementing a CBW system