ArticleBMJ public health2026
What does resilience and well-being mean to community health workers? An exploratory study in the upper east region, Ghana.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Community Health Workers (CHWs) are critical in achieving universal health coverage, particularly in resource-constrained settings where they often work under demanding social, structural, and health system conditions. However, CHWs' experiences of resilience and well-being in their social and work contexts have received limited attention. Considering the critical role CHWs play in sustaining primary healthcare and understanding their resilience and well-being is vital to workforce sustainability and health system performance. This study explores how CHWs in the Upper East Region of Ghana understand and experience resilience and well-being to gain insight into the multidimensional and culturally grounded nature of these constructs. Methods: A qualitative study was conducted in two districts in the Upper East Region, Ghana using a phenomenological approach. The analysis therefore centres on CHWs' own accounts and interpretations of resilience and well-being as situated within their work and sociocultural contexts. Semi-structured interviews were conducted with 16 CHWs, selected to ensure diversity in gender, experience and geographical location. Interpretative phenomenological analysis was used to capture lived experiences and their underlying meanings. Results: CHWs accounts suggest that resilience is a dynamic process involving cognitive and adaptive strategies, emotional regulation, communal solidarity and spiritual coping mechanisms. They described resilience as shaped by the interplay of individual agency, social support systems and cultural beliefs. Well-being was described as holistic, considering environmental, financial, mental, emotional, physical, social and spiritual aspects, emphasising the interconnectedness of multiple dimensions. While both female and male CHWs described resilience across all dimensions, their coping strategies revealed subtle but important nuances. Conclusion: Resilience and well-being as described by CHWs in Ghana are complex and dynamic experiences shaped by contextual processes. Efforts to understand and support CHWs' resilience and well-being must reflect this complexity, highlighting the relational, communal and spiritual dimensions in addition to individual capacities. Culturally and gender-sensitive, context-responsive strategies are essential for informing policies and practices that promote CHW resilience and well-being, as well as support the sustainability of community health systems.
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