Does Inter-Border Conflict Influence the Views of Task Sharing Among Community Health Volunteers in Nigeria? a Qualitative Study

2021 ◽  
Author(s):  
Luret Albert Lar ◽  
Martyn Stewart ◽  
Sunday Isiyaku ◽  
Laura Dean ◽  
Kim Ozano ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Human Resources For Health ◽  
Community Support ◽  
World Health ◽  
Task Sharing ◽  
Structured Interviews ◽  
Factors Affecting ◽  
Allocation Process

Abstract Background: Volunteer community health workers are increasingly being engaged in Nigeria, through the World Health Organization’s task sharing strategy. This strategy aims to address gaps in human resources for health, including inequitable distribution of health workers. Recent conflicts in rural and fragile border communities in northcentral Nigeria create challenges for volunteer community health workers to meet their communities increasing health needs. This study aimed to explore the perception of volunteers involved in task sharing to understand factors affecting performance and delivery in such contexts.Methods: Eighteen audio recorded, semi-structured interviews with volunteers and supervisors were conducted. Their perceptions on on how task sharing and allocation affect performance and delivery were elucidated. The transactional social framework was applied during the thematic analysis process to generate an explanatory account of the research data.Results: Promotive and preventive tasks were shared among the predominantly agrarian respondents. There was a structured task allocation process that linked the community with the health system and mainly cordial relationships were in place. However, there were barriers related to ethnoreligious crises and current conflict, timing of task allocations, gender inequities in volunteerism, shortage of commodities, inadequate incentives, dwindling community support and negative attitudes of some volunteers.Conclusion: The perception of task sharing was mainly positive, despite the challenges, especially the current conflict. In this fragile context, reconsideration of non-seasonal task allocations within improved community-driven selection and security systems should be encouraged. Supportive supervision and providing adequate and timely renumerations will also be beneficial in this fragile setting.

Evaluation of the effectiveness of community health workers in the fight against malaria in the Central African Republic (2012–2017)

2019 ◽  
Vol 114 (3) ◽  
pp. 173-184
Author(s):  
Djerandouba Yotobumbeti Ferdinand ◽  
Bessimbaye Nadlaou ◽  
Nzalapan Samuel ◽  
Bekaka Youlet Oscar ◽  
Mbailao Raphael ◽  
...  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Access ◽  
Central African Republic ◽  
Health Workers ◽  
Preventive Health Services ◽  
Structured Interviews ◽  
Adequate Treatment ◽  
Care Access

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.

scholarly journals Contextual factors affecting the integration of community health workers into the health system in Limpopo Province, South Africa

2019 ◽  
Vol 12 (4) ◽  
pp. 281-286 ◽  
Author(s):  
Geoffrey Jobson ◽  
Nireshni Naidoo ◽  
Nthabiseng Matlakala ◽  
Gert Marincowitz ◽  
Jean Railton ◽  
...  
Keyword(s):  
South Africa ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Limpopo Province ◽  
Community Members ◽  
Middle Income ◽  
Factors Affecting ◽  
Challenges And Opportunities ◽  
Decision Making Processes

Abstract Background Community health workers (CHWs) are an essential cadre in the health systems of many low- and middle-income countries. These workers provide a wide variety of services and are key to ongoing processes of task shifting within human immunodeficiency virus programmes in particular. Ward-based outreach teams (WBOTs) are South Africa’s latest iteration of the CHW programme and have been introduced as part of the National Department of Health’s Primary Health Care Re-engineering programme. Methods In order to assess the perceived effectiveness of the WBOTs in supporting the ongoing rollout of antiretroviral therapy, tuberculosis care and patient support, we conducted a qualitative investigation focusing on the perceived successes and challenges of the programme among CHWs, community leaders, healthcare workers and community members in the Mopani district, Limpopo province, South Africa. Results The CHW programme operates across these contexts, each associated with its own set of challenges and opportunities. Conclusions While these challenges may be interrelated, a contextual analysis provides a useful means of understanding the programme’s implementation as part of ongoing decision-making processes.

scholarly journals Factors affecting recruitment and retention of community health workers in a newborn care intervention in Bangladesh

2010 ◽  
Vol 8 (1) ◽  
Author(s):  
Syed Moshfiqur Rahman ◽  
Nabeel Ashraf Ali ◽  
Larissa Jennings ◽  
M Habibur R Seraji ◽  
Ishtiaq Mannan ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Newborn Care ◽  
Factors Affecting ◽  
Recruitment And Retention ◽  
Care Intervention

scholarly journals Community Health Workers for Non-Communicable Diseases Prevention and Control in Bangladesh: A Qualitative Study

2020 ◽  
Author(s):  
Lal Rawal ◽  
Shamim Jubayer ◽  
Shohel R Choudhury ◽  
Sheikh Mohammad Shariful Islam ◽  
Abu Abdullah
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Prevention And Control ◽  
Health Workers ◽  
Community Support ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Non Communicable Diseases ◽  
And Control ◽  
Central Level

Abstract Objective: To examine the barriers and facilitators to engaging Community Health Workers (CHWs) for Non-communicable Diseases (NCDs) prevention and control in Bangladesh.Design: We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection, and data were analysed thematically.Setting: Data were collected from health facilities across three districts in Bangladesh, and two stakeholder consultative meetings were conducted at the central level.Participants: We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n=4); key informant interviews with central level health policymakers/ managers (n=15) and focus group discussions with CHWs (4 FGDs; total n=29). Participants in a stakeholder consultative meeting included members from the government (n=4), non-government organisations (n=2), private sector (n=1) and universities (n=2).Results: The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispatching of basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. The facilitating factors to engage CHWs included government commitment and program priority, development of NCD related policies and strategies, the establishment of NCD corners, community support systems, social recognition and staff motivation.Conclusion: Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for capacity building of CHWs, systems-level support and maximizing CHWs engagement to prevention and control of NCDs in Bangladesh.

scholarly journals How should community health workers in fragile contexts be supported: Qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo

2020 ◽  
Author(s):  
Joanna Raven ◽  
Haja Wurie ◽  
Ayesha Idriss ◽  
Abdulai Jawo Bah ◽  
Amuda Baba ◽  
...  
Keyword(s):  
Community Health ◽  
Sierra Leone ◽  
Community Health Workers ◽  
Democratic Republic ◽  
Health Workers ◽  
Democratic Republic Of Congo ◽  
Community Support ◽  
Health Coverage ◽  
Republic Of Congo ◽  
And Performance

Abstract Background: Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods: We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n=37), life history interviews with CHWs (n=15) and reviewed policy documents. Results: Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role. This has implications for the selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs scope of work is varied and may change over time, requiring ongoing training. The modular, local, and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and developing a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is vital to retention and performance of CHWs. But there are challenges with supervision, scarcity of supplies, inadequate community recognition and unfulfilled promises about allowances. Clear communication about incentives with facility staff and communities is required as is their timely delivery.Conclusions: This is the first study that has explored the management of CHWs in fragile settings. CHWs interface role between communities and health systems is critical because of their embedded positionality and the trusting relationships they (often) have. Their challenges are aligned to those generally faced by CHWs but chronic fragility exacerbates them and requires innovative problem solving to ensure that countries and communities are not left behind in reforming the way that CHWs are supported.

scholarly journals Experiences of midwives and community health workers using mHealth to improve services to pregnant women in rural Burkina Faso, Africa

2019 ◽  
Vol 10 (3) ◽  
pp. 57
Author(s):  
Antonia LDC Arnaert ◽  
Norma Ponzoni ◽  
Zoumanan Debe ◽  
Mouoboum Marc Meda ◽  
Noufou Gustave Nana ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Health Center ◽  
Structured Interviews ◽  
Center Staff ◽  
Work Related ◽  
Qualitative Descriptive

Objective: This qualitative, descriptive study explored the experiences of midwives and community health workers (CHWs) using mhealth to improve the care provided to pregnant women living in the rural Diapangou region of Burkina Faso, Africa.Methods: Semi-structured interviews were conducted with 4 CHWs and 4 community health center staff. Transcripts were content analyzed.Results: Despite internet connectivity challenges all participants agreed that mhealth allowed them to provide better maternal care. The service enhanced their practice collectively, through facilitating better follow-up care, promoting communication and collaboration, and facilitated management while simplifying administrative tasks. From a managerial perspective, having access to productivity information allowed for effective oversight and supervision of work-related activities. CHWs perceived additional work responsibilities and an opportunity for growth; however, both CHWs and staff recognized that the exposure to technology allowed them to achieve mastery of basic computer skills.Conclusions: The ‘digital divide’ remains a challenge in low resource settings, thus while findings are promising, Burkina Faso will have to wait to reap the full benefits of digital technology until a supportive infrastructure can be put in place.

Sign in / Sign up

Export Citation Format

Share Document