OBJECTIVES:

Most deaths can be averted through simple evidence-based interventions such as the use of Community Health Workers (CHWs). However, the CHW strategy still faces implementation challenges regarding training packages, supervision, and motivation. The WHO advocates for the use of CHWs to expand health services coverage, as one of the method to tackle health workers shortages mostly in developing countries.

METHODS:

CHWs were invited to share their perspectives and experiences on their role: Qualitative interviews (In-depth interviews) with 15 CHWs from three districts i.e. Kamuli, Pallisa and Kibuku explored their motivations, as well as the challenges they encountered. Each CHW was also interviewed independently, which gave insight into the practical day-to-day activities that they engage in.

RESULTS:

CHWs mentioned that the key motivation for taking on their role was elevating their status in their community, but the main barrier was lack of confidence resulting from lack of appropriate training and supervision. In-depth interviews revealed that CHWs, contrary to literature, are the ‘front line’ health workers regarding basic health care, which extends to all preventive diseases. Complex health issues like medication defaulters have been addressed by CHWs and they are the ‘first responders to community emergencies.

CONCLUSIONS:

With decentralization level one of the health care systems is now the village or LC 1 where CHWs are found. CHWs are key health support staff who shoulder a significant burden of care at community level. CHWs are very crucial in expanding health coverage mostly in rural and underserved communities. This has reduced the burden on health facility staff. However, lack of training and other materials that CHWs lack, make them feel ill-equipped to deal with the challenges that they encounter on a daily basis. CHWs are likely to be the magic bullet towards improved household health care.