Mwaniki Ann Wanyaga, Nyaboga John Muge, Mecha Ezekiel Onyonka, Oyugi Boniface
County Government of Machakos, Department of Health Services, County Government of Machakos, Machakos Highway, P.O Box 2574-90100, Machakos, Kenya.
Department of Biochemistry, University of Nairobi, 30197-00100, Nairobi, Kenya.
Prim Health Care Res Dev. 2025 Jul 30;26:e65. doi: 10.1017/S1463423625100248.
This study explored the enablers and challenges influencing the performance of community health volunteers (CHVs) in Machakos County, Kenya, during the COVID-19 pandemic.
The COVID-19 pandemic disrupted healthcare systems globally, with particularly severe impacts in developing countries. Community health workers (CHWs) played a critical role in crisis communication, community engagement, case detection, referrals, and maintaining care continuity. However, limited evidence exists on the factors enabling and hindering their performance during the pandemic.
This study employed a convergent mixed-methods design, integrating focus group discussions (FGDs), in-depth interviews (IDIs), and structured data extraction from the Kenya Health Information System (KHIS). Analysis of the data was guided by Agarwal et al.'s conceptual framework for measuring community health workforce performance with the quantitative data being analyzed using descriptive statistics, while qualitative data being analyzed through thematic analysis.
CHVs effectively disseminated COVID-19 information, addressed vaccine hesitancy, and mobilized communities, supported by training, supervision, and community recognition. Their efforts led to significant improvements in healthcare services, including increased household visits, immunizations, and maternal health referrals. Despite their contributions, CHVs faced challenges such as delayed stipends, limited resources, and occasional community stigma, which hindered performance. Social support networks, community appreciation, and priority healthcare access emerged as key enablers, fostering resilience and motivation. Improved reporting mechanisms also highlighted CHVs' expanded roles during the pandemic.
This study underscores the critical role of CHVs in sustaining healthcare services during the COVID-19 pandemic, despite facing financial, logistical, and social barriers. Their resilience and adaptability led to significant improvements in key health services, supported by effective supervision and training. Strengthening systemic support, integrating CHVs into long-term strategies, and enhancing community recognition are essential to maximize their impact in future health challenges.
本研究探讨了在新冠疫情期间，影响肯尼亚马查科斯县社区卫生志愿者（CHV）工作表现的促进因素和挑战。
新冠疫情扰乱了全球医疗体系，对发展中国家影响尤为严重。社区卫生工作者（CHW）在危机沟通、社区参与、病例发现、转诊及维持护理连续性方面发挥了关键作用。然而，关于疫情期间影响其工作表现的促进和阻碍因素的证据有限。
本研究采用了收敛性混合方法设计，整合了焦点小组讨论（FGD）、深入访谈（IDI）以及从肯尼亚卫生信息系统（KHIS）中提取的结构化数据。数据的分析以阿加瓦尔等人用于衡量社区卫生人力绩效的概念框架为指导，定量数据采用描述性统计进行分析，而定性数据则通过主题分析进行分析。
在培训、监督和社区认可的支持下，社区卫生志愿者有效地传播了新冠疫情信息，解决了疫苗犹豫问题，并动员了社区。他们的努力使医疗服务得到显著改善，包括增加了家访、免疫接种和孕产妇健康转诊。尽管做出了贡献，但社区卫生志愿者仍面临津贴延迟、资源有限以及偶尔的社区污名化等挑战，这些都阻碍了他们的工作表现。社会支持网络、社区认可和优先获得医疗服务成为关键的促进因素，增强了他们的适应能力和积极性。改进的报告机制也凸显了社区卫生志愿者在疫情期间扩大的作用。
本研究强调了社区卫生志愿者在新冠疫情期间维持医疗服务方面的关键作用，尽管面临财务、后勤和社会障碍。他们的适应能力和应变能力在有效的监督和培训支持下，使关键卫生服务得到显著改善。加强系统支持、将社区卫生志愿者纳入长期战略以及提高社区认可度对于在未来卫生挑战中最大化他们的影响至关重要。
