ArticlePloS one2020
Equity for health delivery: Opportunity costs and benefits among Community Health Workers in Rwanda.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Workload and emerging challenges of community health workers in low- and middle-income countries: A mixed-methods systematic review.PloS one · 2023Pooled it
- Global Pathways to Thriving Children: Implementing Large-Scale Multicomponent Nutrition and Child Development Programs.The Journal of nutrition · 2026Article
- Driving NCD screening at scale: outcomes of a digital, CHW-led hypertension surveillance program in rural Rwanda.BMC public health · 2026Article
- Community-based intervention to reach the last mile of childhood vaccination coverage in Burera district, Rwanda: a mixed method study.BMC public health · 2026Article
- Mass drug administration for soil-transmitted helminthiasis and schistosomiasis in selected districts of Rwanda: Coverage, implementation factors, and household water, sanitation, and hygiene conditions.PLoS neglected tropical diseases · 2026Article
- Hepatitis B treatment response and factors associated with HBV treatment success: A population-based study in Rwanda.Hepatology communications · 2026Article
- Article
- Clinically accountable school health: a case for extending primary care into schools.Frontiers in public health · 2026Article
- Costs and cost-effectiveness of integrated horizontal community health worker programmes in low- and middle-income countries (2015-2024): a scoping literature review.BMJ global health · 2025Article
- Geographical coverage and dominant socio-demographic profiles of community health workers in Togo.BMC health services research · 2025Article
- A qualitative exploration of cultural illness perceptions and barriers to modern healthcare: the case of Ikirimi and traditional uvulectomy in Rwanda.Journal of ethnobiology and ethnomedicine · 2025Article
- How community-based health workers fulfil their roles in epidemic disease surveillance: a case study from Burkina Faso.BMC health services research · 2024Article
- Transition and change: opportunities and challenges of CHW programme reform for community health systems and vertical disease programmes in Liberia.Health research policy and systems · 2024Article
- Integrating trauma- and violence-informed care for adolescent mothers in Rwanda: a qualitative study with community health workers.BMC health services research · 2024Article
- Evidence of community health workers' delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review.BMJ open · 2024Article
- The Vicious Worm education tool improves the knowledge of community health workers on Taenia solium cysticercosis in Rwanda.PLoS neglected tropical diseases · 2024Article
- Availability of antimalarial medicines and inventory management at the community level: a case study of Bugesera district in Rwanda.BMC health services research · 2024Article
- A time-motion study of community health workers delivering community-based primary health care in Neno District, Malawi.Human resources for health · 2023Article
- Article
- Knowledge and practices surrounding outbreaks and COVID-19 among community health workers in rural Rwanda: a cross-sectional mixed-methods study.The Pan African medical journal · 2023Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Community Health Workers (CHWs) play a vital role delivering health services to vulnerable populations in low resource settings. In Rwanda, CHWs provide village-level care focused on maternal/child health, control of infectious diseases, and health education, but do not receive salaries for these services. CHWs make up the largest single group involved in health delivery in the country; however, limited information is available regarding the socio-economic circumstances and satisfaction levels of this workforce. Such information can support governments aiming to control infectious diseases and alleviate poverty through enhanced healthcare delivery. The objectives of this study were to (1) evaluate CHW opportunity costs, (2) identify drivers for CHW motivation, job satisfaction and care provision, and (3) report CHW ideas for improving retention and service delivery. In this mixed-methods study, our team conducted in-depth interviews with 145 CHWs from three districts (Kirehe, Kayonza, Burera) to collect information on household economics and experiences in delivering healthcare. Across the three districts, CHWs contributed approximately four hours of volunteer work per day (range: 0-12 hrs/day), which translated to 127 684 RWF per year (range: 2 359-2 247 807 RWF/yr) in lost personal income. CHW out-of-pocket expenditures (e.g. patient transportation) were estimated at 36 228 RWF per year (range: 3 600-364 800 RWF/yr). Participants identified many benefits to being CHWs, including free healthcare training, improved social status, and the satisfaction of helping others. They also identified challenges, such as aging equipment, discrepancies in financial reimbursements, poverty, and lack of formal workspaces or working hours. Lastly, CHWs provided perspectives on reasonable and feasible improvements to village-level health programming that could improve conditions and equity for those providing and using the CHW system.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.