ArticleHuman resources for health2015
Exploring competing experiences and expectations of the revitalized community health worker programme in Mozambique: an equity analysis.
Article in Human resources for health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Community health workers and health equity in low- and middle-income countries: systematic review and recommendations for policy and practice.International journal for equity in health · 2022Pooled it
- Who is a community health worker? - a systematic review of definitions.Global health action · 2017Pooled it
- "Like a broom tied together": A qualitative exploration of social cohesion and its role in community capacity strengthening to support integrated health in Nigeria.PLOS global public health · 2023Article
- Perceptions of Community Health Workers (CHW) on barriers and enablers to care for people with psychosis in rural Mozambique: findings of a focus group discussion study using the Capability, Opportunity, Motivation and Behaviour framework (COM-B framework).Human resources for health · 2022Article
- How should community health workers in fragile contexts be supported: qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo.Human resources for health · 2020Article
- Redressing the gender imbalance: a qualitative analysis of recruitment and retention in Mozambique's community health workforce.Human resources for health · 2020Article
- Exploring perceptions, barriers, and enablers for delivery of primary ear and hearing care by community health workers: a photovoice study in Mukono District, Uganda.International journal for equity in health · 2020Article
- Strengthening referral systems in community health programs: a qualitative study in two rural districts of Maputo Province, Mozambique.BMC health services research · 2019Article
- Policy review on the management of pre-eclampsia and eclampsia by community health workers in Mozambique.Human resources for health · 2019Review
- Close-to-community providers of health care: increasing evidence of how to bridge community and health systems.Human resources for health · 2016Article
- Close to community health providers post 2015: Realising their role in responsive health systems and addressing gendered social determinants of health.BMC proceedings · 2015Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMozambique launched its revitalized community health programme in 2010 in response to inequitable coverage and quality of health services. The programme is focused on health promotion and disease prevention, with 20 % of community health workers' (known in Mozambique as Agentes Polivalentes Elementares (APEs)) time spent on curative services and 80 % on activities promoting health and preventing illness. We set out to conduct a health system and equity analysis, exploring experiences and expectations of APEs, community members and healthcare workers supervising APEs.
methodsThis exploratory qualitative study captured the perspectives of a range of participants including women caring for children under 5 years (service clients), community leaders, service providers (APEs) and their supervisors. Participants in the Moamba and Manhiça districts, located in Maputo Province (Mozambique), were selected purposively. In total, 29 in-depth interviews and 9 focus group discussions were conducted in the local language and/or Portuguese. A framework approach was used for analysis, assisted by NVivo10 software.
resultsOur analysis revealed that health equity is viewed as linked to the quality and coverage of the APE programme. Demand and supply factors interplay to shape health equity. The availability of responsive and appropriate services led to tensions between community expectations for curative services (and APEs' willingness to perform them) and official policy focusing APE efforts mainly on preventive services and health promotion. The demand for more curative services by community members is a result of having limited access to healthcare services other than those offered by APEs.
conclusionThis study highlights the need to pay attention to the determinants of demand and supply of community interventions in health, to understand the opportunities and challenges of the difficult interface role played by APEs and to create communication among stakeholders in order to build a stronger, more effective and equitable community programme.
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