Review Article

Community Health Worker programmes’ integration into national health systems: Scoping review

Lucia M. Mupara, John J.O. Mogaka, William R. Brieger, Joyce M. Tsoka-Gwegweni
African Journal of Primary Health Care & Family Medicine | Vol 15, No 1 | a3204 | DOI: https://doi.org/10.4102/phcfm.v15i1.3204 | © 2023 Lucia M. Mupara, John J.O. Mogaka, William R. Brieger, Joyce M. Tsoka-Gwegweni | This work is licensed under CC Attribution 4.0
Submitted: 18 August 2021 | Published: 09 March 2023

About the author(s)

Lucia M. Mupara, Department of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
John J.O. Mogaka, Department of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
William R. Brieger, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
Joyce M. Tsoka-Gwegweni, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Abstract

Background: Community health worker (CHW) programmes, when adequately integrated into mainstream health systems, can provide a viable, affordable and sustainable path to strengthened health systems that better meets demands for improved child health, especially in resource-constrained settings. However, studies that report on how CHW programmes are integrated into respective health systems in sub-Saharan Africa (SSA) are missing.

Aim: This review presents evidence on CHW programmes’ integration into National Health Systems for improved health outcomes in SSA.

Setting: Sub-Saharan Africa.

Method: Six CHW programmes representing three sub-Saharan regions (West, East, and Southern Africa) were purposively selected based on their deemed integration into respective National Health Systems. A database search of literature limited to the identified programmes was then conducted. Screening and literature selection was guided a scoping review framework. Abstracted data were synthesised and presented in a narrative form.

Results: A total of 42 publications met the inclusion criteria. Reviewed papers had an even focus on all six CHW programmes integration components. Although some similarities were observed, evidence of integration on most CHW programme integration components varied across countries. The linkage of CHW programmes to respective health systems runs across all reviewed countries. Some CHW programme components such as CHW recruitment, education and certification, service delivery, supervision, information management, and equipment and supplies are integrated into the health systems differently across the region.

Conclusion: Different approaches to the integration of all the components depict complexity in the field of CHW programme integration in the region.

Contribution: The study presents synthesized evidence on CHW programmes integration into national health systems in SSA.


Keywords

community health work; Integration; CHW programmes; health systems strengthening; national health systems; improved health outcomes; Sub-Saharan Africa.

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