scholarly journals A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint

2014 ◽  
Vol 1 (2) ◽  
pp. 29-41 ◽  
Author(s):  
Bradly Alexander Kimbrough ◽  
Lisa Baker
Author(s):  
Germaine Tuyisenge ◽  
Valorie A. Crooks ◽  
Nicole S. Berry

Abstract Background In Rwanda, community health workers (CHWs) are an integral part of the health system. For maternal health, CHWs are involved in linking members of the communities in which they live to the formal health care system to address preventative, routine, and acute maternal care needs. Drawing on the findings from in-depth interviews with maternal health CHWs and observational insights in ten Rwandan districts, we identify specific strategies CHWs employ to provide equitable maternal care while operating in a low resource setting. Methods Using case study methodology approach, we conducted interviews with 22 maternal health CHWs to understand the nature of their roles in facilitating equitable access to maternal care in Rwanda at the community level. Interviews were conducted in five Rwandan districts. Participants shared their experiences of and perceptions on promoting equitable access to maternal health service in their communities. Results Four key themes emerged during the analytic process that characterize the contexts and strategic ways in which maternal health CHWs facilitate equitable access to maternal care in an environment of resource scarcity. They are: 1) community building; 2) physical landscapes, which serve as barriers or facilitators both to women’s care access and CHWs’ equitable service provision; 3) the post-crisis socio-political environment in Rwanda, which highlights resilience and the need to promote maternal health subsequent to the genocide of 1994; and, 4) the strategies used by CHWs to circumvent the constraints of a resource-poor setting and provide equitable maternal health services at the community level. Conclusion Rwanda’s maternal CHWs are heavily responsible for promoting equitable access to maternal health services. Consequently, they may be required to use their own resources for their practice, which could jeopardize their own socio-economic welfare and capacity to meet the demands of their families. Considering the unpaid and untrained nature of this position, we highlight the factors that threaten the sustainability of CHWs’ role to facilitate equitable access to maternal care. These threats introduce turbulence into what is a relatively successful community-level health care initiative.


Author(s):  
Gahizi Emmanuel ◽  
Andi Wahju Rahardjo Emanuel ◽  
Djoko Budiyanto Setyohadi

Community health workers (CHWs) are the basis of public health services that aim to connect the gap between public health and the human service system. This gap can be completely bridged by navigating the health and human service systems and educating communities on disease prevention. Unfortunately, the way of sharing, accessing information, and delivering health services is still non-digitalized in Rwanda. Community Health workers use a manual system in their daily activities, which is prone to error and falsification. Moreover, these people selected to perform these activities often do not have adequate knowledge about diseases and health systems since they are not professional health workers. To address the above problem, we designed a prototype mobile application to enable these workers to automatically submit reports, transfer knowledge, share information, and receive training from professionals.  The design process followed a User-Centered Design approach to meet the users’ requirements. The evaluation of the design showed that 91.7% of the CHWs agreed with the designed application prototype.  This finding shows that CHWs has an interest in using the mobile application in their work. Using the mobile application will help CHWs to improve data collection, the reporting process, and ease of receiving training.


2019 ◽  
Vol 114 (3) ◽  
pp. 173-184
Author(s):  
Djerandouba Yotobumbeti Ferdinand ◽  
Bessimbaye Nadlaou ◽  
Nzalapan Samuel ◽  
Bekaka Youlet Oscar ◽  
Mbailao Raphael ◽  
...  

Abstract Background This last decade’s ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR. Methods Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers). Results From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building. Conclusions CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities.


2012 ◽  
Vol 17 (5) ◽  
pp. 622-629 ◽  
Author(s):  
Martha K. Mwangome ◽  
Greg Fegan ◽  
Ronald Mbunya ◽  
Andrew M. Prentice ◽  
James A. Berkley

2017 ◽  
Vol 12 (2) ◽  
pp. 55-61
Author(s):  
Thi Hoai Thu Nguyen ◽  
Fiona McDonald ◽  
Andrew Wilson

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam. Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis. Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities. Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres. Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.


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