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Workload and emerging challenges of community health workers in low- and middle-income countries: A mixed-methods systematic review

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  • Tigist Astale
  • Tsegereda Abebe
  • Getnet Mitike

Abstract

Background: Community health workers (CHWs) play an important role in improving access to health services to a broader population; particularly to communities living in remote areas. However, the productivity of CHWs is affected by the workload they have. We aimed to summarize and present CHWs’ perceived workload in low-and middle-income countries (LMICs). Methods: We searched three electronic databases (PubMed, Scopus, and Embase). A search strategy customized for the three electronic databases was developed using the two key terms of the review (CHWs and workload). Primary studies conducted in LMICs that explicitly measured workload of CHWs and published in English were included, without date restrictions. Methodological quality of the articles was assessed by two reviewers independently using mixed-methods appraisal tool. We applied a convergent integrated approach to synthesize the data. This study is registered on PROSPERO, number CRD42021291133. Results: Of 632 unique records, 44 met our inclusion criteria, and 43 (20 qualitative, 13 mixed-methods, and 10 quantitative studies) passed the methodological quality assessment and were included in this review. In 97.7% (n = 42) of the articles, CHWs reported that they have a high workload. Having multiple tasks was the most commonly reported subcomponent of workload, followed by lack of transport; which was reported in 77.6% (n = 33) and 25.6% (n = 11) of the articles respectively. Conclusion: CHWs in LMICs reported that they have a high workload; mainly related to having to manage multiple tasks and the lack of transport to access households. Program managers need to make careful consideration when additional tasks are shifted to CHWs and the practicability to be performed in the environment they work in. Further research is also required to make a comprehensive measure of the workload of CHWs in LMICs.

Suggested Citation

  • Tigist Astale & Tsegereda Abebe & Getnet Mitike, 2023. "Workload and emerging challenges of community health workers in low- and middle-income countries: A mixed-methods systematic review," PLOS ONE, Public Library of Science, vol. 18(3), pages 1-11, March.
    • Handle: RePEc:plo:pone00:0282717
    DOI: 10.1371/journal.pone.0282717
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    References listed on IDEAS

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    1. Wilson Majee & Laura Schopp & Levona Johnson & Adaobi Anakwe & Anthea Rhoda & Jose Frantz, 2020. "Emerging from the Shadows: Intrinsic and Extrinsic Factors Facing Community Health Workers in Western Cape, South Africa," IJERPH, MDPI, vol. 17(9), pages 1-12, May.
    2. Abimbola Olaniran & Barbara Madaj & Sarah Bar‐Zeev & Aduragbemi Banke‐Thomas & Nynke van den Broek, 2022. "Factors influencing motivation and job satisfaction of community health workers in Africa and Asia—A multi‐country study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 112-132, January.
    3. Olaniran, Abimbola & Madaj, Barbara & Bar Zeev, Sarah & Banke-Thomas, Aduragbemi & van den Broek, Nynke, 2022. "Factors influencing motivation and job satisfaction of community health workers in Africa and Asia - a multi-country study," LSE Research Online Documents on Economics 111837, London School of Economics and Political Science, LSE Library.
    4. Janna M Schurer & Kelly Fowler & Ellen Rafferty & Ornella Masimbi & Jean Muhire & Olivia Rozanski & Hellen J Amuguni, 2020. "Equity for health delivery: Opportunity costs and benefits among Community Health Workers in Rwanda," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-18, September.
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