Submission ID 118433
| Issue/Objective | In Bangladesh, community health workers (CHWs) are integral to delivering essential health services in both urban and rural areas. During the COVID-19 pandemic, CHWs in urban low-income areas faced major disruptions in their routine work due to pre-existing barriers such as overcrowding, inadequate healthcare infrastructure, and high dependency on CHWs. This study aimed at exploring the experiences and challenges faced by CHWs during the COVID-19 pandemic, understand the strategies they employed to cope, and derive actionable recommendations for future health crisis preparedness. |
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| Methodology/Approach | We carried out community-based participatory research using qualitative methods, which included two focus group discussions (FGDs) with CHWs. A sample of 16 female CHWs affiliated with various NGOs providing services to urban informal settlements located in the icddr,b's HDSS sites in Dhaka and Tongi, Gazipur, were selected purposively. We used a structured guide with open-ended questions to facilitate the discussion. Thematic content analysis was carried out to identify emerging themes around service disruptions, adaptation strategies, safety and training gaps, mobility barriers, and community rejection. |
| Results | The CHWs reported significant challenges in delivering essential health services, including antenatal and postnatal care, routine immunizations, and gender-based violence counseling during the pandemic due to the suspension of door-to-door service. Shifts in roles and the addition of new responsibilities related to COVID-19 awareness and prevention increased their workload. Though most CHWs received basic COVID-19 safety guidelines via virtual meetings, inadequate training, lack of direct supervision and data on HRIS from urban, limited access to personal protective equipment (PPE), lack of financial incentives, and restricted public transportation were reported as major constraints in delivering services in the community. Moreover, widespread fear and misinformation about COVID-19 resulted in social stigma and discrimination against CHWs, further impeding their ability to provide care and creating personal and professional hardships. |
| Discussion/Conclusion | The COVID-19 pandemic exposed the vulnerabilities and resilience of CHWs working in underserved urban communities. Strengthening training, ensuring adequate protective measures, and supporting the mental health and social well-being of CHWs are critical for future public health crisis responses. |
| Presenters and affiliations | Md. Zamiur Rahaman International Centre for Diarrhoeal Disease Research, Bangladesh Monika Akter International Centre for Diarrhoeal Disease Research, Bangladesh Sohana Shafique International Centre for Diarrhoeal Disease Research, Bangladesh Foyjunnaher Sultana International Centre for Diarrhoeal Disease Research, Bangladesh Fatima Tuz-Zannat International Centre for Diarrhoeal Disease Research, Bangladesh |
