Amref Health Africa, Nairobi, Kenya.
University of Nairobi, Nairobi, Kenya.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319211073415. doi: 10.1177/21501319211073415.
Coronavirus disease (COVID-19) caused socio-economic disruptions across the globe. The pandemic disrupted the health system (HS) calling for reengineering in response to high infection rates, deaths, and resultant containment measures. To deal with COVID-19 and promote resilience, community health workers (CHWs) were engaged across countries.
Assess the preparedness of CHWs in supporting health system response in prevention and management of COVID-19 in Kenya, Senegal, and Uganda.
A mixed methods design study involving national and subnational jurisdictions in the 3 countries. Key informant interviews were conducted with policy actors (16) and health care workers (24) while in-depth interviews involved CHWs (14) and community members (312) subjected to survey interviews.
Most (>50%) households survived on <USD 100/month during COVID-19 announced in March 2020 through national TV (57%), FM (42%), and radio station (27%). Community members interactions with CHWs increased during the pandemic through home visits as health educators, basic counseling providers and distributors of pandemic information tools, personal protective equipments, and social support commodities. The CHWs faced challenges during pandemic prevention and management including lack of: protective gear, salary, refresher courses, and identification tools; limited supervision and training; hostile reception during home visits; misconception and politicking about the pandemic. To effectively support prevention and manage of COVID-19, priority needs for CHWs were identified namely: provision of resources, protective gear, transport reimbursement, stipends, identification cards, and tools for recording and reporting; empowerment with adequate skills, trainings on provision of psychosocial support, first aid, and sensitization on policies.
COVID-19 linked disruptions to optimal functioning of HS necessitated engagement of CHWs in the pandemic prevention and management. Findings underscore the important role CHWs play in supporting HS during crisis like COVID-19 to mitigate disruptions and stabilize the system for effective response. The CHWs can improve resilience of social and HS during unplanned disruptions for optimal functioning and attainment of universal health care. Policy makers should develop structured mechanisms for engaging CHWs while committing resources to address challenges that affect seamless synergy between health and CHWs Systems.
冠状病毒病（COVID-19）在全球范围内造成了社会经济的混乱。大流行扰乱了卫生系统（HS），要求对其进行重新设计，以应对高感染率、高死亡率和由此产生的遏制措施。为了应对 COVID-19 并提高韧性，社区卫生工作者（CHWs）在各国被聘用。
评估肯尼亚、塞内加尔和乌干达的 CHWs 在支持卫生系统预防和管理 COVID-19 方面的准备情况。
一项混合方法设计研究，涉及 3 个国家的国家和国家以下各级。对政策行为者（16 人）和卫生保健工作者（24 人）进行了关键知情人访谈，而对 CHWs（14 人）和社区成员（312 人）进行了深入访谈，并进行了调查访谈。
大多数（>50%）家庭在 2020 年 3 月宣布 COVID-19 时每月靠<100 美元生活（通过国家电视台 57%、调频广播 42%和广播电台 27%）。在大流行期间，社区成员与 CHWs 的互动增加了，CHWs 作为健康教育者、基本咨询提供者以及大流行信息工具、个人防护装备和社会支持商品的分发者，进行家访。CHWs 在大流行的预防和管理中面临挑战，包括缺乏：防护装备、工资、进修课程和身份识别工具；监督和培训有限；家访时受到敌对接待；对大流行的误解和政治化。为了有效支持 COVID-19 的预防和管理，确定了 CHWs 的优先需求，即：提供资源、防护装备、交通报销、津贴、身份证和记录和报告工具；赋予足够的技能、提供心理社会支持、急救培训以及对政策的敏感度。
与 COVID-19 相关的卫生系统功能障碍需要社区卫生工作者参与大流行的预防和管理。研究结果强调了 CHWs 在支持危机期间的卫生系统（如 COVID-19）方面的重要作用，以减轻干扰并为有效应对稳定系统。CHWs 可以在计划外干扰期间提高社会和卫生系统的恢复力，以实现最佳运作和普及医疗保健。政策制定者应制定结构化的机制来吸引 CHWs，并承诺投入资源解决影响卫生系统和 CHWs 系统之间无缝协同的挑战。
