By: Mark Mwenda

Since January 2024, CHW Central has noticed a wealth of publications focusing on Community Health Workers (CHWs) across East Africa: 64 articles to be specific. In this summary of the recent evidence, I offer insights into the current state of CHW programs in the region and what the research tells us, including key learnings, challenges, and lingering questions that continue to shape the landscape of community health services in the region. By exploring the effectiveness, challenges, and innovations surrounding CHW programs, this brief summary highlights the critical role CHWs play in advancing healthcare in East Africa and the gaps that remain unaddressed.

Community Health Workers (CHWs) hold a unique and vital position within East Africa’s healthcare systems. They are often the first, and sometimes the only, link between remote, underserved communities and the broader medical world. They are the people who walk miles to provide care, educate communities, and ensure that health services reach even the most isolated populations (Nkurunziza et al. 2024). As I sifted through the recent research on CHWs across East Africa, I found myself reflecting on the significant challenges and the substantial promise that CHWs represent.

The studies I reviewed collectively paint a picture of CHWs as indispensable pillars of health systems, particularly in rural and underserved areas. CHWs are instrumental in addressing a wide range of health issues in the region, from maternal and child health to infectious diseases and chronic conditions (Semakula et al. 2024; Benoni et al. 2024). Their work is broad and impactful, but it is also fraught with challenges that, if not addressed, could undermine their effectiveness.

Health Education and Disease Prevention

A recurring theme across these studies is the critical role that CHWs play in health education and disease prevention (Musyimi et al. 2024; Chiziba and Silal 2024). Their close relationships with the communities they serve allow them to be effective educators, tailoring health messages in ways that resonate with local customs, languages, and beliefs (Onyango, Masinde, and Ouma 2024). This personalized approach often results in better health outcomes, as community members are more likely to trust and follow the advice of someone they know and respect (Asiimwe and Kadubira 2024).

In addition to their roles in health education and disease prevention, CHWs have made substantial contributions to the management of chronic and infectious diseases, as well as maternal and child health (MCH). Studies highlight how CHWs are instrumental in improving access to care for individuals with HIV, tuberculosis, diabetes, and hypertension, particularly in rural areas where healthcare services are limited (Semakula et al. 2024; Wallender et al. 2024; Kanyike et al. 2024; Youngui et al. 2024). CHWs support patients by offering home-based care, monitoring adherence to treatment regimens, and facilitating timely referrals to health facilities (Kanyike et al. 2024).

Furthermore, CHWs have played a critical role in reducing maternal and infant mortality by providing antenatal care, assisting with safe childbirth practices, and ensuring follow-up care for newborns and mothers (Gazeley et al. 2024; Awobode and Ansie 2024; Matte et al. 2024). Their ability to provide culturally sensitive and community-centered care significantly enhances the reach and effectiveness of health interventions targeting both chronic and infectious diseases, as well as MCH (Milka 2024; Youngui et al. 2024).

Data Collection

CHWs play a pivotal role in data collection, which is crucial for defining community health needs and shaping local health services. Several studies emphasize how CHWs, with their close ties to communities, are uniquely positioned to gather accurate, real-time data on health trends, disease outbreaks, and socio-economic conditions (Musoke et al. 2024; Manzi et al. 2024). This data informs local health policies and helps healthcare providers and policymakers tailor interventions to the specific needs of the community. For example, CHWs have been involved in mapping vaccination coverage gaps, identifying populations at risk of malnutrition, and monitoring the spread of infectious diseases, contributing to more responsive health service planning (Albin et al. 2024; Manzi et al. 2024). Their engagement in data collection also fosters community trust and ownership of health initiatives, as it ensures that health services are aligned with local priorities and challenges (Kanyike et al. 2024). By involving CHWs in data collection (and analysis), health systems become more adaptable and better equipped to meet the dynamic needs of the populations they serve.

Reducing Costs

One of the most compelling arguments for investing in CHW programs is their potential to reduce healthcare costs while improving outcomes (Manzi et al. 2024; Asiimwe and Kadubira 2024). By providing preventive care and managing chronic conditions at the community level, CHWs can help reduce the need for expensive hospital visits and treatments. This is especially important in resource-limited settings, where healthcare budgets are often stretched thin (Wambui et al. 2024). Yet, for this potential to be realized, CHW programs need stable funding, effective management, and continuous evaluation to ensure they are meeting their goals (Awobode and Ansie 2024).

Cultural Competence

A particularly striking aspect of the studies published so far this year is the emphasis on the importance of cultural competence in CHW programs (Milka 2024; Albin et al. 2024). CHWs often come from the communities they serve, which gives them a deep understanding of local customs, beliefs, and practices. This cultural competence is a powerful asset, allowing CHWs to deliver care in a way that is respectful and effective (Norr et al. 2024). However, the research also points to the need for ongoing training to ensure that CHWs can navigate cultural sensitivities, particularly as health issues evolve and new challenges arise (Uwibambe et al. 2024; Elias et al. 2024).

CHWs do not work in isolation, community support is an essential ingredient in the success of CHW programs (Plaisance et al. 2024). They are part of a broader community fabric that includes local leaders, health facilities, and other stakeholders. When communities actively support CHWs—through respect, cooperation, and local resources—these programs tend to be more successful (Otiso et al. 2024; Razafinjato et al. 2024). Conversely, when CHWs are undervalued or unsupported by their communities, their work becomes much more challenging.

Climate Change and Health

Climate change is increasingly recognized as a significant factor influencing the effectiveness and sustainability of Community Health Worker (CHW) programs across East Africa. As climate patterns shift, CHWs are often on the frontlines, dealing with the health consequences of these changes, such as increased incidences of vector-borne diseases, malnutrition, and waterborne illnesses. Extreme weather events like floods and droughts further complicate their work, as they struggle to reach affected populations, often in remote areas with limited infrastructure (Owoputi et al. 2024). These challenges not only strain the already limited resources of CHW programs but also highlight the need for climate-resilient health systems. Integrating climate change adaptation strategies into CHW programs is becoming increasingly crucial, ensuring that these essential workers are equipped to handle the growing health impacts of a changing environment.

“CHWs are often the first, and sometimes the only, link between remote, underserved communities and the broader medical world.”

Persistent Gaps

Despite the significant contributions CHWs make, the research highlights several gaps that need urgent attention. One of the most glaring is the inconsistency in training and supervision (Salomão et al. 2024; Ilboudo et al. 2024; Kwiringira et al. 2024). While some CHWs receive comprehensive training and ongoing support, others are left to navigate complex health challenges with minimal guidance (Kansiime et al. 2024). This disparity in training not only affects the quality of care CHWs can provide but also puts them at risk of burnout, as they are often expected to handle situations beyond their capacity (Pamba et al. 2024).

Compounding this issue is the lack of standardized compensation and support for CHWs in the region (Owoputi et al. 2024; Steinhaus et al. 2024; Davis et al. 2024). Many CHWs work as volunteers or receive very little pay for their efforts, which can lead to high attrition rates (Mulogo et al. 2024). The studies suggest that this lack of financial stability not only affects the well-being of CHWs but also the sustainability of CHW programs (Astawesegn et al. 2024). When CHWs leave their positions due to financial pressures, communities lose valuable health resources, and the continuity of care is disrupted (Olakkengil et al. 2024).

The research also indicates that there is a notable gap in the integration of CHWs into the broader health system (Mapulanga et al. 2024; Lee et al. 2024). While CHWs are often seen as an extension of the health system, they are sometimes left out of critical decision-making processes (Musyimi et al. 2024). This exclusion can lead to misaligned priorities and missed opportunities to leverage the unique insights CHWs bring from their communities (Garchitorena et al. 2024). Integrating CHWs more fully into the health system—ensuring they have a voice in planning and policy-making—could enhance their effectiveness and the overall responsiveness of health services.

CHWs need  better tools and technologies to support their work (Mazimpaka et al. 2024). While some programs, such as Ethiopia and Kenya, have introduced mobile health (mHealth) solutions to improve communication and data collection, these technologies are not yet widely accessible or fully integrated (Hailemariam et al. 2024). The potential of digital tools to enhance the efficiency and reach of CHWs is enormous, but it remains largely untapped due to factors like cost, training, and infrastructure limitations (Kachimanga et al. 2024).

No Surprises

One striking realization from the 2024 publications so far is that much of the evidence presented reaffirms what has been known for years. The value of Community Health Workers (CHWs) and the barriers to their success are well-documented, and the recent literature largely echoes these familiar themes. While these studies continue to shed light on critical issues—such as the need for better training, more sustainable funding, and stronger policy support—these are challenges that have been consistently highlighted in the past.

This raises an important point: the real challenge we face is not merely in accumulating more evidence about the importance of CHW programs or the obstacles they encounter. Rather, the challenge lies in mobilizing the political will and securing the necessary investments to turn this knowledge into action. The recurring themes in the literature underscore a broader issue—an urgent need for tangible steps to be taken by governments, implementing partners, and CHW associations (where they exist) to address the persistent gaps.

Reflections on the State of the Evidence

Reflecting on these findings, I am struck by the incredible potential of CHWs to transform healthcare in East Africa. They are already doing so much with so little, but with the right support, their impact could be even greater. Addressing the gaps in training, compensation, integration, technology, and community support is not just about improving CHW programs—it is about strengthening the entire health system.

These insights resonate with my own experiences and aspirations in the field of community health. As someone deeply committed to the well-being of communities, I see the empowerment of CHWs as a crucial step toward achieving health equity in East Africa. It is clear that CHWs are not just foot soldiers in the fight for better health; they are leaders, educators, and advocates who hold the key to a healthier future for all.

Moving forward, it is essential that policymakers, healthcare providers, and communities work together to address the challenges facing CHWs. This means investing in their training and support, ensuring they are fairly compensated, and integrating them more fully into the health system. It also means embracing new technologies that can help CHWs work more efficiently and effectively.

The lack of advocacy for CHWs remains a significant barrier to governments fully recognizing and appreciating the critical role they play in healthcare systems. One potential solution to this challenge is the development of strong, unified CHW associations. These associations could serve as a powerful platform for CHWs to collectively advocate for their rights, better working conditions, and sustainable employment models. By amplifying the voices of CHWs, associations could engage policymakers, secure long-term funding, and ensure that CHWs are fully integrated into national health systems. Moreover, CHW associations could offer professional development opportunities, standardize training, and provide a structure for ongoing peer support, all of which would enhance the effectiveness and retention of CHWs. In many regions, similar professional groups have been instrumental in influencing health policy and driving systemic change, and CHW associations could play a vital role in transforming the way community health services are valued and delivered.

Ultimately, the future of healthcare in East Africa—and indeed, in many parts of the world—depends on the success of CHW programs. By addressing the gaps identified in these studies and building on the strengths of CHWs, we can create a more just, equitable, and effective healthcare system. It is a vision that I am committed to pursuing, and I believe that with collective effort, it is a vision that can be realized.

The story of CHWs in East Africa is one of resilience, dedication, and hope. It is a story that deserves our attention, our investment, and our support. As we look to the future, let us not forget the vital role that CHWs play in our communities—and let us do everything we can to ensure they have the tools, resources, and respect they need to continue their essential work.

Bibliography

1. Abdul, Ramadhani, Tobias F R. Wit, Giulia Martelli, Kathleen Costigan, Patrobas Katambi, Anton Pozniak, Werner Maokola, Sayoki Mfinanga, and Sabine Hermans. 2024. Stability in care and risk of loss to follow-up among clients receiving community health worker-led differentiated HIV care: Results from a prospective cohort study in northern Tanzania, (1). https://doi.org/10.1111/tmi.13975.
2. Ahmed, Jehan, Adam Nothem, Jadmin Mostel, Annie Ciceron, Luigi Nuñez, Oméga Raobela, Andry P. Raoiliarison, et al. 2024. Experiences in Improving the Quality of Community-Based Fever Management from Three Malaria-Endemic African Countries, (1). https://doi.org/10.4269/ajtmh.23-0488.
3. Albin, Maria Q., Gloria Igihozo, Shuko Musemangezhi, Edith N. Namukanga, Theogene Uwizeyimana, Gebremariam Alemayehu, Abebe Bekele, Rex Wong, and Chester Kalinda. 2024. “When we have served meat, my husband comes first”: A qualitative analysis of child nutrition among urban and rural communities of Rwanda, (7). https://doi.org/10.1371/journal.pone.0306444.
4. Asiimwe, John B., and Eriot Kadubira. 2024. Timeliness of Malaria Treatment in Children Under Five Years in Uganda: An Analysis of 2016 Demographic Health Survey Data, (7). https://doi.org/10.21203/rs.3.rs-4726273/v1.
5. Astawesegn, Feleke H., Haider Mannan, Virginia Stulz, and Elizabeth Conroy. 2024. Understanding the uptake and determinants of prevention of mother-to-child transmission of HIV services in East Africa: Mixed methods systematic review and meta-analysis, (4). https://doi.org/10.1371/journal.pone.0300606.
6. Awobode, Janet, and Vera Ansie. 2024. Leveraging Community Health Workers as a Novel Approach to Reduce Maternal Mortality: A Discourse Analysis, (4). https://www.ilomata.org/index.php/ijss/article/view/1122.
7. Benoni, Roberto, Chiara Malesani, Anna Sartorello, Hamilton Cardoso, Izilda Chaguruca, Chivite Alamo, Giovanni Putoto, et al. 2024. Assessing the impact of a community-based psychodrama intervention on mental health promotion of adolescents and young adults in Mozambique, (7). https://doi.org/10.7189/jogh.14.04182.
8. Byansi, William, Ozge S. Bahar, Latoya Small, Phionah Namatovu, Josephine Nabayinda, Joshua Kiyingi, Abel Mwebembezi, et al. 2024. The longitudinal impact of an evidence-based multiple family group intervention (Amaka Amasanyufu) on family cohesion among children in Uganda: Analysis of the cluster randomized SMART Africa-Uganda scale-up study (2016-2022), (5). https://doi.org/10.1111/famp.13007.
9. Chiziba, Chilochibi, and Sheetal Silal. 2024. Exploring measures to increase detection of malaria cases through reactive case detection in a Southern Province of Zambia-like Setup, (7). https://www.medrxiv.org/content/10.1101/2024.07.18.24310660v1.
10. Ciccone, Emily J., Di Hu, John S. Preisser, Caitlin A. Cassidy, Lydia Kabugho, Baguma Emmanuel, Georget Kibaba, et al. 2024. Point-of-care C-reactive protein measurement by community health workers safely reduces antimicrobial use among children with respiratory illness: results from a stepped wedge cluster-randomized trial in rural Uganda, (5). https://doi.org/10.1101/2024.05.22.24307733.
11. Davis, Alyssa L., Lola Flomen, Jehan Ahmed, Djibrilla M. Arouna, Amos Asiedu, Maman B. Badamassi, Ousmane Badolo, et al. 2024. Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study, (6). https://doi.org/10.9745/ghsp-d-24-00008.
12. Dillip, Angel, Gloria Kahamba, Richard Sambaiga, Elizabeth Shekalaghe, Ntuli Kapologwe, Erick Kitali, James T. Kengia, et al. 2024. Using digital technology as a platform to strengthen the continuum of care at community level for maternal, child and adolescent health in Tanzania: introducing the Afya-Tek program, (7). https://doi.org/10.1186/s12913-024-11302-7.
13. Drown, Laura, Alemayehu Amberbir, Alula M. Teklu, Meseret Zelalem, Abreham Tariku, Yared Tadesse, Solomon Gebeyehu, et al. 2024. Reducing the equity gap in under-5 mortality through an innovative community health program in Ethiopia: an implementation research study, (2). https://doi.org/10.1186/s12887-023-04388-1.
14. Elias, Hussein, Evelyne Kisembe, Sarah Nyariki, Ivan Kiplimo, ames Amisi, Juli Boit, Allison Tarus, Naseem Mohamed, and Kenneth Cornetta. 2024. Impact of training on knowledge, confidence and attitude amongst community health volunteers in the provision of community-based palliative care in rural Kenya, (4). https://doi.org/10.1186/s12904-024-01415-5.
15. Faye, Sylvain L., Maud M. Lugand, André T. Offianan, Aurélie Dossou-Yovo, Dieudonné K. Kouadio, and Felix Pinto. 2024. Field testing of user-friendly perennial malaria chemoprevention packaging in Benin, Côte d’Ivoire and Mozambique, (5). https://doi.org/10.1186/s12936-024-04977-0.
16. Gakinahe, Godelive U., Eugene Rutungwa, Francois Mbonyinshuti, and Egide Kayitare. 2024. Availability of antimalarial medicines and inventory management at the community level: a case study of Bugesera district in Rwanda, (1). https://doi.org/10.1186/s12913-024-10605-z.
17. Garchitorena, Andres, Aina Harimanana, Judickaelle Irinantenaina, Hobisoa L. Razanadranaivo, Tsinjo F. Rasoanaivo, Dean Sayre, Julie R. Gutman, et al. 2024. Expanding community case management of malaria to all ages can improve universal access to malaria diagnosis and treatment: results from a cluster randomized trial in Madagascar, (6). https://doi.org/10.1186/s12916-024-03441-9.
18. Gazeley, Ursula, Marvine C. Ochieng, Onesmus Wanje, Angela Koech, Grace Mwashigadi, Nathan Barreh, Alice M. Kombo, et al. 2024. Postpartum recovery after severe maternal morbidity in Kilifi, Kenya: A Grounded Theory of recovery trajectories beyond 42 days, (5). https://kclpure.kcl.ac.uk/portal/en/publications/postpartum-recovery-after-severe-maternal-morbidity-in-kilifi-ken.
19. Hailemariam, Tesfahun, Asmamaw Atnafu, Lemma Gezie, Jens Kaasbøll, Jorn Klein, and Binyam Tilahun. 2024. Intention to Use an Electronic Community Health Information System Among Health Extension Workers in Rural Northwest Ethiopia: Cross-Sectional Study Using the Unified Theory of Acceptance and Use of Technology 2 Model, (3). https://doi.org/10.2196/47081.
20. Hoeven, Marinka v., Monique v. Lettow, Pien Boonstra, Trynke Hoekstra, Elizeus Rutebemberwa, Raymond Tweheyo, and Maarten O. Kok. 2024. Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda, (2). https://doi.org/10.1136/bmjopen-2023-074393.
21. Ilboudo, Patrick G., Hermann Pythagore P. Donfouet, Calistus Wilunda, Bernardette Cichon, Daniel Tewoldeberhan, James Njiru, Emily Keane, et al. 2024. Treatment of moderate acute malnutrition through community health volunteers is a cost-effective intervention: Evidence from a resource-limited setting, (7). https://doi.org/10.1111/mcn.13695.
22. Kachimanga, Chiyembekezo, Manuel Mulwafu, Myness K. Ndambo, Jimmy Harare, Joia Murkherjee, Alexandra V. Kulinkina, Simon Mbae, Enoch Ndarama, Thomas v. Akker, and Ibukun O. Abejirinde. 2024. Experiences of community health workers on adopting mHealth in rural Malawi: A qualitative study, (5). https://doi.org/10.1177/20552076241253994.
23. Kamanzi, Collins, Eric Matsiko, Lawrence Rugema, Aline Umubyeyi, and Lucy Kanya. 2024. The role of community health workers in COVID-19 home-based care: Lessons learned from Rwanda. https://iris.who.int/bitstream/handle/10665/375812/9789290314936-eng.pdf?sequence=4&isAllowed=y.
24. Kansiime, Winnifred K., Edwinah Atusingwize, Rawlance Ndejjo, Emmanuel Balinda, Moses Ntanda, Richard K. Mugambe, and David Musoke. 2024. Barriers and benefits of mHealth for community health workers in integrated community case management of childhood diseases in Banda Parish, Kampala, Uganda: a cross-sectional study, (5). https://doi.org/10.1186/s12875-024-02430-4.
25. Kanyike, Andrew M., Raymond B. Kihumuro, Timothy M. Kintu, Lee Seungwon, Ashley W. Nakawuki, Kevin Apio, and Richard Katuramu. 2024. Feasibility of Community-based Hypertension Screening and Referral by Village Health Teams in Eastern Uganda: a Quasi-experimental Study, (6). https://doi.org/10.21203/rs.3.rs-4481238/v1.
26. Kletter, Maartje, Bronwyn Harris, Emilia Connolly, Chifundo Namathanga, Basimenye Nhlema, Henry Makungwa, Benson Chabwera, Benson Phiri, and Celia Brown. 2024. Mixed method evaluation of a learning from excellence programme for community health workers in Neno, Malawi, (3). https://doi.org/10.1186/s12913-024-10686-w.
27. Kwiringira, Andrew, Richard Migisha, Lilian Bulage, Benon Kwesiga, Daniel Kadobera, George Upenytho, Paul Mbaka, Julie R. Harris, Donald Hayes, and Alex R. Ario. 2024. Group-based Education and monitoring program delivered by community health workers to improve control of high blood pressure in island districts of lake victoria, Uganda, (5). https://doi.org/10.1186/s12875-024-02444-y.
28. Lee, Seungwon, Samuel Kasibante, Adam Eminai, Solomon Wani, Didan J. Opii, Lisa D. Levine, and Andrew M. Kanyike. 2024. Effectiveness Of a Community Health Worker-Led Education Intervention on Knowledge, Attitude, and Antenatal Care Attendance of Pregnant Women in Eastern Uganda. A Quasi- Experimental Study, (6). https://doi.org/10.21203/rs.3.rs-4560055/v1.
29. Manzi, Anatole, Benjamin Katz, Daniel Nguyen, Emrakabe Bekele, Joseph Niyonzima, Olive Nyiraneza, and Lisa R. Hirschhorn. 2024. Optimizing community health workers and non-biomedical approaches to assess the burden of soil-transmitted helminthiasis in a school-aged population in rural Rwanda, (6). https://doi.org/10.21203/rs.3.rs-4413143/v1.
30. Manzi, Anatole, Daniel Nguyen, Benjamin Katz, Theophile Nilingiyimana, Clara A. Michel, Titien Sendarasi, Joseph Niyonzima, Olive Nyiraneza, Norbert B. Bimenyimana, and Elizabeth Bloom. 2024. Factors associated with perceived health of school-aged children in rural Rwanda: An opportunity to leverage community health workers to enhance primary healthcare systems linkages, (6). https://doi.org/10.21203/rs.3.rs-4409830/v1.
31. Mapulanga, Miriam, Kabelo Kgarosi, Kuhlula Maluleke, Mbuzeleni Hlongwa, and Thembelihle Dlungwane. 2024. Evidence of community health workers’ delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review, (5). https://doi.org/10.1136/bmjopen-2023-079738.
32. Matte, Michael, Moses X Moses Ntaro, Jessica Kenney, Andrew Wesuta, Peter C. Kawungezi, Shem Bwambale, David Ayebare, et al. 2024. Assessment of pre-referral treatment for malaria, diarrhea, and pneumonia by rural community health workers in Southwestern Uganda: a cross-sectional study, (1). https://doi.org/10.1186/s12913-024-10598-9.
33. Matte, Michael, Moses Ntaro, Jessica Kenney, Palka Patel, Andrew C. Wesuta, Peter C. Kawungezi, Shem Bwambale, et al. 2024. Management of children with danger signs in integrated community case management care in rural southwestern Uganda (2014–2018), (3). https://doi.org/10.1093/inthealth/ihad039.
34. Mazimpaka, Christian, Yves Sangwa, Victor Ndaruhutse, Samson Radeny, Dieudonne Ndatimana, François Niragire, Beatrice Mukamana, et al. 2024. Using eLearning to improve and retain knowledge of community health workers in maternal and neonatal health in Rwanda: A prospective cohort study, (5). https://doi.org/10.22541/au.171550290.05251383/v1.
35. Mezei, Alex, Jessica Trawin, Beth Payne, Angeli Rawat, Priscilla Naguti, Jackson Orem, Melanie C. Murray, Carolyn Nakisige, and Gina Ogilvie. 2024. Acceptability of Integrated Community-Based HIV and Cervical Cancer Screening in Mayuge District, Uganda, (1). https://doi.org/10.1200/go.22.00324.
36. Milka, Pietilä. 2024. Spatial Determinants of Health and Culture : health promotion project for TB and HIV Co-Infection in Kisumu- Kenya, (6). https://urn.fi/URN:NBN:fi:amk-2024053119450.
37. Mulogo, Edgar, Moses Ntaro, Andrew Wesuta, Jane Namusisi, Peter Kawungezi, Vincent Batwala, and Michael Matte. 2024. Cost-effectiveness of village health worker-led integrated community case management (iCCM) versus health facility based management for childhood illnesses in rural southwestern Uganda, (5). https://doi.org/10.1186/s12936-024-04962-7.
38. Mulubwa, Chama, Joseph M. Zulu, Anna-Karin Hurtig, and Isabel Goicolea. 2024. Being both a grandmother and a health worker: experiences of community-based health workers in addressing adolescents’ sexual and reproductive health needs in rural Zambia, (5). https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18685-6.
39. MUNYANEZA, Emmanuel, Viviane UMUTESI, Esperance MUHAWENAYO, Espoir M. NGABO, Joel NSHUMUYIKI, Alphonsine IMANISHIMWE, Jean P. NGANABASHAKA, et al. 2024. Surgical Site Infection Prevention Training of Community Health workers in Rwanda., (7). https://doi.org/10.62463/surgery.78.
40. Musoke, David, Grace B. Lubega, Belinda Twesigye, Betty Nakachwa, Michael O. Brown, and Linda Gibson. 2024. Enhancing the capacity of community health workers in prevention and control of epidemics and pandemics in Wakiso district, Uganda: evaluation of a pilot project, (7). https://doi.org/10.1186/s12875-024-02522-1.
41. Musyimi, Christine W., Levi A. Muyela, David M. Ndetei, Sara E. Lacko, and Nicolas Farina. 2024. Acceptability and Feasibility of a Community Dementia Stigma Reduction Program in Kenya, (6). https://doi.org/10.3233/jad-240192.
42. Ngabirano, Augustino, and Mathew C. Igwe. 2024. Reinvigorating the Village Health Teams in Mitooma District, Uganda: Current Effectiveness, Associated Factors, and Challenges, (5). https://doi.org/10.21203/rs.3.rs-4381923/v1.
43. Nkurunziza, Aimable, Victoria L. Smye, C. N. Wathen, Kimberley T. Jackson, David F. Cechetto, Panagiota Tryphonopoulos, and Darius Gishoma. 2024. Integrating trauma- and violence-informed care for adolescent mothers in Rwanda 1 (1): 15. https://doi.org/10.1186/s12913-024-11352-x.
44. Norr, Kathleen F., Chimwemwe K. Banda, Cecilia Chang, Shruthi Krishna, Lily C. Kumbani, Li Liu, Linda L. McCreary, and Crystal L. Patil. 2024. Condom use increased after a peer group intervention implemented by community volunteers in Malawi, (6). https://doi.org/10.1186/s12889-024-18991-z.
45. Nsekuye, Olivier, Samuel S. Malamba, Ziad El-Khatib, Jared Omolo, Jean-Louis N. Mangara, Dunia Munyakanage, Aline Uwimana, et al. 2024. Indoor residual spraying uptake and its effect on malaria morbidity in Ngoma district, Eastern province of Rwanda, 2018-2021, (3). https://doi.org/10.21203/rs.3.rs-4122368/v1.
46. Odwe, George, Wilson Liambila, Kezia K’Oduol, Zipporah Nyangacha, Helen Gwaro, Alexandra H. Kamberos, and Lisa R. Hirschhorn. 2024. Factors influencing community-facility linkage for case management of possible serious bacterial infections among young infants in Kenya, (1). https://doi.org/10.1093/heapol/czad113.
47. Ogutu, Emily A., Anna S. Ellis, Kyra A. Hester, Katie Rodriguez, Zoe Sakas, Chandni Jaishwal, Chenmua Yang, et al. 2024. Success in vaccination programming through community health workers: a qualitative analysis of interviews and focus group discussions from Nepal, Senegal and Zambia, (4). https://doi.org/10.1136/bmjopen-2023-079358.
48. Olakkengil, Michelle, Samira Said, Omar Abdalla, Rachel Hofmann, Bethany H. Gauthier, and Isabel Fulcher. 2024. Are populations of postpartum women differentially served by community health worker programs: an observational cohort study from Zanzibar, Tanzania, (3). https://doi.org/10.1186/s12884-024-06356-8.
49. Onyango, Ochomo E., David Masinde, and Collins Ouma. 2024. Enhancing cervical cancer knowledge among women of reproductive age: a dialogue-based community health education intervention in rural Kisumu County, Kenya, (6). https://doi.org/10.1186/s12905-024-03075-2.
50. Otiso, Lilian, Yussif Alhassan, Tom Odhong, Boniface Onyango, Nelly Muturi, Charlotte Hemingway, Lois Murray, et al. 2024. Exploring acceptability, opportunities, and challenges of community-based home pregnancy testing for early antenatal care initiation in rural Kenya, (6). https://doi.org/10.1186/s12889-024-19254-7.
51. Owoputi, Ibukun, John Hoddinott, Rosemary Kayanda, Rachel B. Kerr, and Katherine Dickin. 2024. COMMUNITY HEALTH WORKERS’ TARGETING OF WOMEN FOR HEALTH AND NUTRITION HOME VISITS IN RURAL TANZANIA: A MIXED-METHODS STUDY, (5). https://www.sciencedirect.com/science/article/pii/S2475299124017141.
52. Pamba, Doreen, Erica Sanga, Killian Mlalama, Lucas Maganga, Chacha Mangu, Anange Lwilla, Willyhelmina Olomi, et al. 2024. Optimizing delivery strategies for 3HP TB preventive treatment in Tanzania: A qualitative study on acceptability of family approach in HIV care and treatment centers, (4). https://doi.org/10.1101/2024.04.04.24305275.
53. Plaisance, Ariane, Carol-Anne Hyland-Carignan, Diane Tapp, Samiratou Ouedraogo, Idriss A. Gali-Gali, and Anne-Marie Turcotte-Tremblay. 2024. Health promoting palliative care interventions in African low-income countries: a scoping review, (5). https://doi.org/10.1136/bmjph-2023-000402.
54. Razafinjato, Bénédicte, Luc Rakotonirina, Laura F. Cordier, Anna Rasoarivao, Mamy Andrianomenjanahary, Lanto Marovavy, Feno Hanitriniaina, et al. 2024. Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar, (3). https://doi.org/10.1371/journal.pgph.0002888.
55. Riang’a, Roselyter M., Njeri Nyanja, Adelaide Lusambili, Eunice M. Mwangi, Joshua R. Ehrlich, Paul Clyde, Cyprian Mostert, and Anthony Ngugi. 2024. Implementation framework for income generating activities identified by community health volunteers (CHVs): a strategy to reduce attrition rate in Kilifi County, Kenya, (1). https://doi.org/10.1186/s12913-023-10514-7.
56. Salomão, Cristolde, Talata Sawadogo-Lewis, Réka M. Cane, António Júnior, Briana Stone, Júlia Sambo, Michael R. Diaz, et al. 2024. Assessment of community health workers activities in six districts of Zambézia Province, Mozambique, (7). https://link.springer.com/article/10.1007/s44250-024-00113-6.
57. Semakula, L., I. Kaikai, S. Zawedde-Muyanja, P. Nerima, J. Bayigga, M. Nansereko, S. G. Aheebwa, et al. 2024. Private pharmacy and community health worker engagement in the provision of TB services, (7). https://doi.org/10.5588/ijtld.23.0439.
58. Steinhaus, Mara C., Tamaryn J. Nicholson, Triantafyllos Pliakas, Abigail Harper, Pamela Lilleston, Tila Mainga, Deborah Milimo, et al. 2024. “Prevalence and risk of burnout among HIV service providers in South Africa and Zambia: findings from the HPTN 071 (PopART) trial.” Prevalence and risk of burnout among HIV service providers in South Africa and Zambia: findings from the HPTN 071 (PopART) trial, (8). https://doi.org/10.1186/s12960-024-00934-9.
59. Tiruneh, Gizachew T., George Odwe, Alexandra H. Kamberos, Kezia K’Oduol, Nebreed Fesseha, Zipporah Moraa, Hellen Gwaro, et al. 2024. Optimizing integration of community-based management of possible serious bacterial infection (PSBI) in young infants into primary healthcare systems in Ethiopia and Kenya: successes and challenges, (3). https://doi.org/10.1186/s12913-024-10679-9.
60. Uwibambe, Esther, Anselme Shyaka, Egide Niyotwagira, Justine Mutoniwase, Eric M. Fèvre, Rupert J. Quinnell, and Chiara Trevisan. 2024. The Vicious Worm education tool improves the knowledge of community health workers on Taenia solium cysticercosis in Rwanda, (4). https://doi.org/10.1371/journal.pntd.0012140.
61. Wallender, Erika, Bupe Kabamba, Marie-Reine I. Rutagwera, Chabu Kangale, John M. Miller, Travis Porter, Maximillian Musunse, et al. 2024. Malaria community case management usage and quality of malaria care in a moderate Plasmodium falciparum burden region of Chadiza District, Zambia, (8). https://doi.org/10.1186/s12936-024-05047-1.
62. Wambui, Elizabeth, Calistus Wilunda, Hermann P. Donfouet, Bonventure Mwangi, Taddese A. Zerfu, Tewoldeberha Daniel, Olivia Agutu, et al. 2024. Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya, (5). https://doi.org/10.1371/journal.pgph.0002564.
63. Weir, Sarah, Cassandra May, Alexa Wills, Erin V. Zanten, Kathryn Nesbit, Alexander Ngalande, and Ruth Kanjirawaya. 2024. Building Local Capacity in a Low-Resource Setting to Increase Access to Health Care: An Evaluation of Blood Pressure Monitoring Training, (2). https://doi.org/10.1177/15248399231225444.
64. Youngui, Boris T., Daniel Atwine, David Otai, Anca Vasiliu, Bob Ssekyanzi, Colette Sih, Rogacien Kana, et al. 2024. Integration of HIV Testing in a Community Intervention for Tuberculosis Screening Among Household Contacts of Patients with Tuberculosis in Cameroon and Uganda, (3). https://doi.org/10.1097%2FQAI.0000000000003379.