Facilitators and Barriers in Collaborations Between Community Health Workers with Primary and Well-Being Providers in Primary Healthcare in Belgium

Abstract

Background: Community health workers (CHWs) play a crucial role in bridging the gap between underserved populations and formal health. Collaborations between CHWs and health and well-being providers in primary healthcare are essential for improving access to and the quality of care for these communities. However, these partnerships require complementary strengths and specific conditions to succeed. This article addresses the limited knowledge on collaborations between CHW and primary health and well-being providers in Belgium’s CHW program. Methods: This study utilized a descriptive qualitative design. First, team collaboration data were gathered using a spreadsheet. Second, semi-structured interviews were conducted separately with 15 CHWs and 18 of their collaboration partners. The results were thematically analyzed. Results: CHWs collaborate with healthcare partners, partners with a social or societal focus, and government and educational institutions. The scope of collaborations spans sharing knowledge, connecting with the target group, and offering support to individual clients. Collaborations with healthcare providers tend to focus on individual referrals, with less reciprocity, while collaborations with other partners contribute more to outreach activities and addressing broader social determinants of health. Shared motivations and collaborative work methods facilitate collaboration, while internal organizational processes, lack of role clarity, and discrepancies can hinder successful collaboration. Conclusions: Strong local partnerships, well-defined roles, and mutual trust are essential for successful collaboration. The study findings highlight the importance of expanding collaborations to meet the diverse and intersecting needs of target groups. Effective program governance and policy are crucial in providing the flexibility necessary to address specific local requirements.