Community health volunteers and their role in health system strengthening in peri-urban areas: A qualitative study of Epworth, Zimbabwe

Abstract

ABSTRACT Background: Community health volunteers remain an increasingly important resource through which to address the global health workforce crisis, in pursuing health system strengthening in low and middle-income areas. The aim of this study was to provide more research attention on community health workers and their role in the pursuit of universal health coverage in resource-limited peri-urban areas, the focus of which was Epworth, Zimbabwe. Methods: A cross-sectional research design was used for an exploratory qualitative study within which data were collected through a documentary search, key informant interviews, focus group discussions and non-participant observation. Data were transcribed into narratives that were then subjected to interpretive thematic analysis. Results: Two main categories of Community Health Volunteers, namely Community Health Workers/Village Health Workers and Peer Educators were reported by key informants and focus group discussion participants. Community Health Workers helped mitigate healthcare worker shortages by performing outreach work whilst Peer Educators did the same at clinics by helping onsite. Findings also revealed that health volunteers were a source of local knowledge, helped navigate the local physical terrain and cultural practices in facilitating the uptake of healthcare interventions in all parts of the community. Local health volunteers were also an important link between local clinics and the community and facilitated beneficial interaction in healthcare. Conclusions: Community health volunteers are an important resource in strengthening health systems in resource-limited peri-urban areas. The sustainability of local health voluntary work in peri-urban communities is however undermined by capacity constraints which in turn undermines progress towards universal health coverage in low-income peri-urban areas.