ArticleBMJ open2022
Rwanda's community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review.Global health action · 2024Pooled it
- Measuring community engagement and trust in community health workers in Haiti, Malawi, and Rwanda: a cross-sectional study.Journal of global 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
- Clinically accountable school health: a case for extending primary care into schools.Frontiers in public health · 2026Article
- Resilience of health systems in Africa to infectious disease shocks: A qualitative evidence synthesis.PLOS global public health · 2026Article
- A scoping review of the roles, challenges, and strategies for enhancing the performance of community health workers in the response against COVID-19 in low- and middle-income countries.BMC primary care · 2025Article
- Barriers to seeking and delivery of essential health services in nine provinces of Afghanistan during the COVID-19 pandemic: community health workers' perspective.BMC health services research · 2025Article
- Article
- The effectiveness of the Sierra Leone health sector's response to COVID-19: a quantitative analysis.BMC health services research · 2025Article
- From criminalization to care: a comparative rights-based policy review of HIV responses in South Asia.Frontiers in public health · 2025Review
- The acceptance of COVID-19 vaccines in Rwanda: a cross-sectional study.BMC public health · 2024Article
- Kidney Impairment in HIV/AIDS Patients Attending Kabutare Level II Teaching Hospital, Southern Province of Rwanda.Rwanda journal of medicine and health sciences · 2024Article
- 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
- Perceptions of male partners on maternal near-miss events experienced by their female partners in Rwanda.PloS one · 2023Article
- Evaluating continuum of maternal and newborn healthcare in Rwanda: evidence from the 2019-2020 Rwanda demographic health survey.BMC pregnancy and childbirth · 2022Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDuring the COVID-19 pandemic, community health workers (CHWs) served as front-line workers in the COVID-19 response while maintaining community health services. We aimed to understand challenges faced by Rwanda's CHWs during a nationwide COVID-19 lockdown that occurred between March and May 2020 by assessing the availability of trainings, supplies and supervision while exploring perceived needs and challenges. DESIGN AND
settingThis study was a mixed-method study conducted in three Rwandan districts: Burera, Kirehe and Kayonza. MAIN OUTCOME AND MEASURE: Using data collected via telephone, we assessed the availability of trainings, supplies and supervision during the first national lockdown, while exploring perceived needs and challenges of CHWs who were engaged in COVID-19 response, in addition to their existing duties of delivering health services in the community.
resultsAmong the 292 quantitative survey participants, CHWs were responsible for a median of 55 households (IQR: 42-79) and visited a median of 30 households (IQR: 11-52) in the month prior to the survey (July 2020). In the previous 12 months, only 164 (56.2%) CHWs reported being trained on any health topic. Gaps in supply availability, particularly for commodities, existed at the start of the lockdown and worsened over the course of the lockdown. Supervision during the lockdown was low, with nearly 10% of CHWs never receiving supervision and only 24% receiving at least three supervision visits during the 3-month lockdown. In qualitative interviews, CHWs additionally described increases in workload, lack of personal protective equipment and COVID-specific training, fear of COVID-19, and difficult working conditions.
conclusionMany challenges faced by CHWs during the lockdown predated COVID-19 and persisted or were exacerbated during the pandemic. To promote the resilience of Rwanda's CHW system, we recommend increased access to PPE; investment in training, supervision and supply chain management; and financial compensation for CHWs.
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