In this paper we draw overall conclusions concerning the Health Workers for
Change (HWFC) methodology as a management and health systems development t
ool. We examine how HWFC has contributed to an elucidation of the four main
themes with which this special Issue is concerned, namely: the value of pa
rticipatory training; the need for gender sensitivity in health services; t
he impact of the HWFC intervention on gender sensitivity and quality of car
e in health services; and the ability to replicate the HWFC intervention in
a variety of cultural and geographical sites. The paper concludes that HWF
C is a useful health systems development tool, discusses other applications
of HWFC beyond those reported in this issue and makes several recommendati
ons concerning its future use.