Community Health Workers' Role in Solving Health Problems at the Community Level in Bénin and Togo

Abstract

The resolution of health problems at the community level requires firm political will on the part of governments and the effective participation of communities in co-management programs and health activities. The objective of this work is to study the role of Community Health Workers (CHWs) in solving health problems at the community level in Benin and Togo, from 2009 to 2015. This is an evaluative study of the quasi-experimental type, with its variant 'here elsewhere'; it was conducted in six health zones in Benin and five health districts in Togo, ail randomly chosen from the list of districts and zones within the regions or departmental directions covered. The study involved 385 community health workers and 6150 heads of households. Female heads of households were predominant. The community health workers were predominantly male and their level of education was secondary school and up. Only level of education, marital status and the matrimonial regime of heads of households were not significantly correlated to their level of knowledge in both Benin and Togo (p>5%). The heads of households had an acceptable knowledge of community health workers and their activities, but the subsequently expected favorable behavior towards health remained low. Thus, the role of CHWs in solving health problems was perceived as weak. For a visible impact of the actions of this new class of agents at the community level, a strong political will is needed from the countries in the implementation of World Health Organisation's recommendations on community health.