Abstract
BackgroundCommunity health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. Evidence suggests that the performance of CHWs in malaria programs varies in different contexts. However, comprehensive frameworks, based on systematic reviews, to guide the analysis of determinants of performance of CHWs in malaria prevention and control programs are lacking.MethodsWe systematically searched Google Scholar, Science Direct, and PubMed including reference lists that had English language publications. We included 16 full text articles that evaluated CHW performance in malaria control. Search terms were used and studies that had performance as an outcome of interest attributed to community-based interventions done by CHWs were included.ResultsSixteen studies were included in the final review and were mostly on malaria Rapid Diagnosis and Treatment, as well as adherence to referral guidelines. Factors determining performance and effective implementation of CHW malaria programs included health system factors such as nature of training of CHWs; type of supervision including feedback process; availability of stocks, supplies, and job aids; nature of work environment and reporting systems; availability of financial resources and transport systems; types of remuneration; health staff confidence in CHWs; and workload. In addition, community dynamics such as nature of community connectedness and support from the community and utilization of services by the community also influenced performance. Furthermore, community health worker characteristics such marital status, sex, and CHW confidence levels also shaped CHW performance.ConclusionsEffectively analyzing and promoting the performance of CHWs in malaria prevention and control programs may require adopting a framework that considers health systems and community factors as well as community health worker characteristics.
Highlights
Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence
The World Health Organization (WHO), in attempting to move toward elimination of malaria, has come up with a strategy that has three main building blocks which are to ensure universal access to malaria prevention, diagnosis, and treatment, to accelerate efforts toward elimination of malaria and attainment of malaria-free status, and to transform malaria surveillance into a core intervention [2]. These building blocks can be best achieved through Primary Health Care (PHC) using the CHW as key actors in the strategy, which most countries adopted after the 1978 Declaration of Alma-Ata [3, 4]
This review focused on trained CHWs who work as community malaria agents (CMAs) carrying out malaria prevention and control interventions in the community
Summary
Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. The World Health Organization (WHO), in attempting to move toward elimination of malaria, has come up with a strategy that has three main building blocks which are to ensure universal access to malaria prevention, diagnosis, and treatment, to accelerate efforts toward elimination of malaria and attainment of malaria-free status, and to transform malaria surveillance into a core intervention [2]. These building blocks can be best achieved through Primary Health Care (PHC) using the CHW as key actors in the strategy, which most countries adopted after the 1978 Declaration of Alma-Ata [3, 4]. This review focused on trained CHWs who work as community malaria agents (CMAs) carrying out malaria prevention and control interventions in the community
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