ArticleGlobal health, science and practice2024
Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study.
Article in Global health, science and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Analysis of the institutionalisation of Integrated Community Case Management and its implications for access to community healthcare since 2019 in Sub-Saharan Africa: a systematic review.BMC primary care · 2026Pooled it
- Eliminating ghost workers and optimizing resources to strengthen Community Health Worker programs in sub-Saharan Africa.PLoS medicine · 2026Article
- Savoring the service: A qualitative study of Latine community health workers' health promotion efforts.PLOS global public health · 2026Article
- Men's perspective on barriers and challenges towards accessing healthcare services in the City of Mbombela, Mpumalanga Province, South Africa.BMC research notes · 2025Article
- Incentives on the motivation and job performance; insights from community health workers in Iran.BMC health services research · 2025Article
- Observing Healthcare Leaders in Action After a Pathways to Leadership for Health Transformation Programme by World Health Organization Regional Office for Africa in Benin and Niger.Journal of healthcare leadership · 2025Article
- Geo-epidemiological risk stratification to select malaria interventions, case of Mali.PLOS global public health · 2025Article
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Authors and funding
17 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionCommunity health worker (CHW) incentives and remuneration are core issues affecting the performance of CHWs and health programs. There is limited documentation on the implementation details of CHW financial compensation schemes used in sub-Saharan African countries, including their mechanisms of delivery and effectiveness. We aimed to document CHW financial compensation schemes and understand CHW, government, and other stakeholder perceptions of their effectiveness.
methodsA total of 68 semistructured interviews were conducted with a range of purposefully selected key informants in 7 countries: Benin, Burkina Faso, Ghana, Malawi, Mali, Niger, and Zambia. Thematic analysis of coded interview data was conducted, and relevant country documentation was reviewed, including any documents referenced by key informants, to provide contextual background for qualitative interpretation.
resultsKey informants described compensation schemes as effective when payments are regular, distributions are consistent, and amounts are sufficient to support health worker performance and continuity of service delivery. CHW compensation schemes associated with an employed worker status and government payroll mechanisms were most often perceived as effective by stakeholders. Compensation schemes associated with a volunteer status were found to vary widely in their delivery mechanisms (e.g., cash or mobile phone distribution) and were perceived as less effective. Lessons learned in implementing CHW compensation schemes involved the need for government leadership, ministerial coordination, community engagement, partner harmonization, and realistic transitional financing plans.
conclusionPolicymakers should consider these findings in designing compensation schemes for CHWs engaged in routine, continuous health service delivery within the context of their country's health service delivery model. Systematic documentation of the tasks and time commitment of volunteer status CHWs could support more recognition of their health system contributions and better determination of commensurate compensation as recommended by the 2018 World Health Organization
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