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Optimising the benefits of community health workers' unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries.

Kok, Maryse C, Ormel, Hermen, Broerse, Jacqueline E W, Kane, Sumit, Namakhoma, Ireen, Otiso, Lilian, Sidat, Moshin, Kea, Aschenaki Z, Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X and Dieleman, Marjolein (2016) 'Optimising the benefits of community health workers' unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries.'. Global public health, Vol 12, Issue 11, pp. 1404-1432.

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Abstract

Community health workers (CHWs) have a unique position between communities and the health sector. The strength of CHWs' relationships with both sides influences their motivation and performance. This qualitative comparative study aimed at understanding similarities and differences in how relationships between CHWs, communities and the health sector were shaped in different Sub-Saharan African settings. The study demonstrates a complex interplay of influences on trust and CHWs' relationships with their communities and actors in the health sector. Mechanisms influencing relationships were feelings of (dis)connectedness, (un)familiarity and serving the same goals, and perceptions of received support, respect, competence, honesty, fairness and recognition. Sometimes, constrained relationships between CHWs and the health sector resulted in weaker relationships between CHWs and communities. The broader context (such as the socio-economic situation) and programme context (related to, for example, task-shifting, volunteering and supervision) in which these mechanisms took place were identified. Policy-makers and programme managers should take into account the broader context and could adjust CHW programmes so that they trigger mechanisms that generate trusting relationships between CHWs, communities and other actors in the health system. This can contribute to enabling CHWs to perform well and responding to the opportunities offered by their unique intermediary position.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 21.5 Allied health personnel. Allied health professions
W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1080/17441692.2016.1174722
Depositing User: Rachel Dominguez
Date Deposited: 10 May 2016 08:47
Last Modified: 03 Oct 2017 10:41
URI: http://archive.lstmed.ac.uk/id/eprint/5874

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