Contested notions of challenges affecting community health workers in low- and middle-income countries informed by the Silences Framework

Musoke, D., Nyashanu, M. ORCID: 0000-0002-9231-0393, Bugembe, H., Lubega, G.B., O’Donovan, J., Halage, A.A. and Gibson, L. ORCID: 0000-0002-1220-8680, 2022. Contested notions of challenges affecting community health workers in low- and middle-income countries informed by the Silences Framework. Human Resources for Health, 20: 4. ISSN 1478-4491

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Abstract

Despite increasing evidence of the challenges affecting Community Health Workers (CHWs) such as those related to training, supportive supervision and remuneration, there is a need to explore concerns and challenges from the perspective of CHWs themselves. This commentary highlights some of the contested and unexplored notions of challenges affecting CHWs in low-and middle-income countries (LMICs) informed by the Silences Framework. This framework defines experiences that are under-explored, misunderstood or difficult to share because of the often invisible power relations within communities, but also in setting the research agenda. These challenges include the heavy workload imposed by several stakeholders, dealing with religious and cultural practices, and gendered barriers of care. The workload of CHWs is a major source of stress and anxiety as they have to balance both government and other stakeholders' agendas to deliver interventions with their own need to provide for their families for those whose work is unpaid. The tensions of CHWs carrying out their work among members of the community whose religious or cultural beliefs are different from theirs also needs to be considered. Gender issues are an impediment to the work of CHWs, particularly with community members of the opposite sex around sensitive health issues. Lastly, CHWs have found themselves victims of domestic suspicion while fulfilling their duties in communities, such as when seen having conversations with spouses of other individuals in the community. Solutions to these challenges need to be co-produced with CHWs to both to strengthen their relationship with the communities they serve and shape more sustainable interventions for delivery of healthcare in LMICs.

Item Type: Journal article
Publication Title: Human Resources for Health
Creators: Musoke, D., Nyashanu, M., Bugembe, H., Lubega, G.B., O’Donovan, J., Halage, A.A. and Gibson, L.
Publisher: Springer
Date: 6 January 2022
Volume: 20
ISSN: 1478-4491
Identifiers:
NumberType
10.1186/s12960-021-00701-0DOI
1506956Other
Rights: © the author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Divisions: Schools > School of Social Sciences
Record created by: Jonathan Gallacher
Date Added: 11 Jan 2022 10:10
Last Modified: 11 Jan 2022 10:10
URI: http://irep.ntu.ac.uk/id/eprint/45236

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