Enhancing Performance and Sustainability of Community Health Worker Programs in Uganda: Lessons and Experiences From Stakeholders

Musoke, David; Atusingwize, Edwinah; Ndejjo, Rawlance; Ssemugabo, Charles; Siebert, Penelope; Gibson, Linda

doi:10.9745/ghsp-d-21-00260

Cited by 4 publications

(2 citation statements)

References 39 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to material development, training, and program evaluation, a few CHWs in our study cited involvement in program design. Such opportunities can be foundational to developing successful programs for clients and further building the workforce [ 39 ]. Existing programs can consider expanding CHWs’ involvement in program development and evaluation to incorporate their valuable perspectives into such efforts.…”

Section: Discussionmentioning

confidence: 99%

Community health worker perspectives: examining current responsibilities and strategies for success

Kowalczyk,

Yao,

Gregory

et al. 2024

Arch Public Health

View full text Add to dashboard Cite

Background Community health worker (CHW) interventions have demonstrated positive impacts globally, with the COVID-19 pandemic further highlighting the potential of CHWs at the frontline to support prevention, outreach, and healthcare delivery. As the workforce expands, understanding the work and capabilities of CHWs is key to design successful interventions. This study examines the perspectives of experienced CHWs in Chicago about their current work and strategies for success. Methods As part of a community-academic partnership in Chicago, semi-structured interviews were completed with individuals who held positions aligned with CHW. Interviews were conducted between January and April 2022. Questions focused on participants’ work and factors contributing to their effectiveness to gain insights into workforce strategies for success to be applied in healthcare and community settings. De-identified transcripts were analyzed using inductive reasoning with codes organized into themes and subthemes under two domains identified a priori. The themes informed a logic model focused on the early stages to support the success of CHWs in their role. Results Fourteen individuals participated in the study. The two predetermined domains in this study were: current work of CHWs and strategies for CHWs to be successful. Five themes were identified about CHWs’ current work: providing services, building alliances with clients, establishing and maintaining collaborations, collecting data, and experiencing challenges in role. From their perspectives, all these responsibilities enhance client care and support workforce sustainability efforts. Five themes emerged about strategies for the success of CHWs: background of CHWs, champions to support work of CHWs, materials to perform work of CHWs, preparation for CHW role, and characteristics of CHWs. Participants described key traits CHWs should possess to be hired, individuals who can champion and advocate for their work, and specific materials needed to fulfill responsibilities. They reported that training and familiarity with the community were integral to developing and refining the qualities and skills necessary to be effective in their role. Conclusion CHWs play an increasingly important role in enhancing healthcare delivery and improving health outcomes. This study offers a framework for policymakers, communities, and organizations to utilize for preparing CHWs to succeed in their roles.

show abstract

Section: Discussionmentioning

confidence: 99%

Community health worker perspectives: examining current responsibilities and strategies for success

Kowalczyk,

Yao,

Gregory

et al. 2024

Arch Public Health

View full text Add to dashboard Cite

show abstract

“…Community members and/or individuals who possess a thorough understanding of the community can become CHWs who serve as culturally competent liaisons between health and social services and the community (14), supporting education, counseling, navigation, and advocacy (15). CHW programs have been utilized globally to address health disparities within clinical and community settings (16)(17)(18)(19). Within clinical settings, CHWs support clinicians to tailor care through their unique connections with patients to understand their needs and situation (20).…”

Section: Introductionmentioning

confidence: 99%

Community health workers' perspectives on integrating into school settings to support student health

Yao

Kowalczyk

Gregory

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

IntroductionWhile schools represent key venues for supporting health, they continue to experience gaps in health resources. The integration of community health workers (CHWs) into schools has the potential to supplement these resources but has been underexplored. This study is the first to examine perspectives of experienced CHWs about how CHWs can be applied in school settings to support student health.MethodsThis qualitative study involved conducting semi-structured interviews focused on implementation of CHWs in schools with individuals who held positions aligned with the CHW scope of work. De-identified transcripts were analyzed, and codes were organized into domains and themes.ResultsAmong 14 participants, seven domains emerged about the implementation of CHWs in schools: roles and responsibilities, collaborations, steps for integration, characteristics of successful CHWs, training, assessment, and potential challenges. Participants shared various potential responsibilities of school-based CHWs, including educating on health topics, addressing social determinants of health, and supporting chronic disease management. Participants emphasized the importance of CHWs building trusting relationships with the school community and identified internal and external collaborations integral to the success of CHWs. Specifically, participants indicated CHWs and schools should together determine CHWs' responsibilities, familiarize CHWs with the school population, introduce CHWs to the school community, and establish support systems for CHWs. Participants identified key characteristics of school-based CHWs, including having familiarity with the broader community, relevant work experience, essential professional skills, and specific personal qualities. Participants highlighted trainings relevant to school-based CHWs, including CHW core skills and health topics. To assess CHWs' impact, participants proposed utilizing evaluation tools, documenting interactions with students, and observing indicators of success within schools. Participants also identified challenges for school-based CHWs to overcome, including pushback from the school community and difficulties related to the scope of work.DiscussionThis study identified how CHWs can have a valuable role in supporting student health and the findings can help inform models to integrate CHWs to ensure healthy school environments.

show abstract

Do cash or digital payment modalities affect community health worker performance? – a case study of a remote refugee settlement in Western Uganda

Wagaba,

Musoke,

Opio

et al. 2024

Global Health Action

View full text Add to dashboard Cite

Background There is inadequate evidence about the influence of digital and cash payment modalities on the performance of Community Health Workers (CHWs) in underserved communities, such as refugee settlements. Objective To compare the performance of CHWs when paid in cash or digitally in Kyaka II refugee settlement, Uganda. Methods A comparative cross-sectional mixed methods design was used. Secondary data comprising 247 CHW reports during a six-month period of cash and digital payments were analyzed using Stata v14. Eleven focus group discussions, four in-depth interviews, and ten key informant interviews were conducted among the settlement stakeholders to explore perceptions of the payment methods. Qualitative data were analyzed thematically using Atlas.ti v9. Results CHWs performed better when paid cash than digital payments ( t = 5.28; df = 246; p < 0.001). During the cash payment period, at least secondary education (APR 1.71 CI: 1.14–2.58) and having a side occupation (APR 1.58; CI: 1.13–2.21) were positively associated with performance. For digital payments, being male (APR 0.58; CI: 0.34–0.98), serving longer than 9 years (APR 0.87; CI: 0.82–0.93), and being allocated more than 60 households per month (APR 0.31; CI: 0.19–0.52) were negatively associated with CHW performance. Qualitative data revealed that most stakeholders preferred cash due to inconsistent and delayed digital payments. Conclusion CHWs preferred and performed better with cash payments because digital payments were associated with delays and payment shortfalls that demotivated them. Implementers should invest towards averting digital payment shortfalls in remote settings to enhance CHW motivation and performance.

show abstract

Enhancing Performance and Sustainability of Community Health Worker Programs in Uganda: Lessons and Experiences From Stakeholders

Abstract: We conducted a 1-day workshop—a unique opportunity to engage stakeholders at all levels of community health worker (CHW) program involvement—to discuss learned experiences and strategies to enhance and sustain the CHW program in Uganda.

Cited by 4 publications

References 39 publications

Community health worker perspectives: examining current responsibilities and strategies for success

Community health worker perspectives: examining current responsibilities and strategies for success

Community health workers' perspectives on integrating into school settings to support student health

Do cash or digital payment modalities affect community health worker performance? – a case study of a remote refugee settlement in Western Uganda

Contact Info

Product

Resources

About