The COVID-19 outbreak that originated in Wuhan City, China, in December 2019 now affects 213 countries or territories across the globe. Better health workforce utilisation and support are key pillars to enhance health systems capacity. Community health workers (CHWs) constitute a significant proportion of frontline health workforce in many countries and play an important role in control and prevention of pandemics like COVID-19.
A rapid evidence synthesis was conducted to understand what role CHWs can play in pandemics. The study found that in previous pandemics, CHWs have played several roles including for generating community awareness countering stigma and contact tracing. CHW engagement in contact tracing might hamper routine primary service delivery. Policies, guidance and training for these had to be developed. Disruption in supply chain, logistics and supportive supervision for CHWs have been common in pandemic scenarios. CHWs have been at increased risk for contracting disease. In the course of pandemics, CHWs have experienced stigmatisation, isolation and socially ostracisation. Improved remuneration, additional incentives, public recognition countering societal stigma, provision of psychosocial support and personal protective equipment were reported to be enablers. There is not much evidence about initialisation of new CHW programmes during pandemics. Considering the complexity of barriers faced even in contexts with well-integrated programmes, ambitious programmes need to be considered with caution.
Read the full study in BMJ Global Health here (open access)
