Co-designing the ‘Empower Community Health’ programme: A capacity-building initiative to support community health workers’ non-communicable disease health promotion in Ethiopia

Abstract

Background: Non-communicable diseases (NCDs) disproportionately affect low- and middle-income countries, including Ethiopia. However, community health workers’ (CHWs’) capacity in NCD health promotion is sometimes limited.
Aim: This study aimed to co-design a contextually appropriate intervention with and for CHWs to support their NCD health promotion services.
Setting: This co-design study was conducted in Gondar City, northwest Ethiopia. The workshops were held in the meeting hall at the University of Gondar.
Methods: A qualitative participatory action research design, guided by the PRODUCES (Problem, Objective, Design, User, Co-creators, Evaluation, and Scalability) framework, was employed. Sixteen participants, including CHWs (n = 6), community-dwelling adults with (n = 3) and without NCD diagnoses (n = 3), and health system managers (n = 4) were recruited using convenience and purposive sampling. Participants attended three workshops. In workshop 1, participants discussed the roles of CHWs in health promotion and areas for improvement. Workshop 2 focused on intervention components and delivery approaches. A draft of the intervention was reviewed during workshop 3. Discussion notes and artefacts were thematically analysed in NVivo.
Results: A 6-week, multicomponent intervention, ‘Empower Community Health’, was co-designed. Key themes included: (1) knowledge capacity building, (2) personal behaviour change, and (3) community-outreach initiatives. Proposed intervention topics included: (1) learning about NCDs; (2) skill motivational interviewing; and (3) behaviour change for diet and physical activity.
Conclusion: The involvement of intervention users and stakeholders allowed for the sharing of experiences and fostered ownership in the ‘Empower Community Health’ programme.
Contribution: The meaningful engagement of stakeholders ensures that the intervention is tailored to their needs, fosters ownership and enhances intervention buy-in. This study provides practical guidance for future co-designed health promotion programmes.