Health has been a sector that is traditionally considered appropriate for women’s employment as it is consistent with their caring role. However in the South Asian context, women community health workers are in fact challenging various social constraints and stereotypes by being engaged in regular employment, in coming out of their homes, being mobile in their communities and fulfilling a socially valued role. A qualitative research study was carried out from March 2008 to explore how women health workers have been instrumental in bringing social change into their communities, whether their role as paid workers has empowered them as women, and if there are discernible changes in gender relations as a consequence of their work. The Bangladesh study compared Government women health workers with non-government women health workers of pioneering programmes in three locations: ICDDR,B; Ganoshathya Kendro and BRAC. The paper which was presented to the 'Pathways: What are we Learning?' Conference held in Cairo from 20-24 January 2009, also explores the differences in the design and conceptualisation of the different programme approaches, working conditions and associated status to examine whether these have made a difference to the women working in these programmes, in terms of their self-perceptions and in terms of how their families and communities value their work. It explores their motivations and that of their families for undertaking the work and the changes in family relations accompanying their employment. Their status as income earners has lead to renegotiations in the roles of the male earners, but not necessarily changes in their positions. Women health workers are expected to have a role in increasing other women’s knowledge and access to health care and reproductive health. The paper will also examine whether the promoters themselves have been able to have greater control over their own reproductive and general health. The women are working in different geographic areas with their own socio-cultural characteristics that also influence the transformations that may take place.