Submission ID 131699
| Issue/Objective | Community health workers (CHWs) play a critical role in health service delivery in development, humanitarian, and resource‑constrained settings. Despite their importance, persistent implementation challenges can undermine the effectiveness of programs delivered by CHWs. The International Federation of the Red Cross and Red Crescent Societies (IFRC) has supported a wide range of CHW initiatives across Africa, generating important operational knowledge and experience. However, lessons from these programs are often documented in isolation and remain largely unconsolidated, leaving gaps in implementation knowledge. To address these gaps, we conducted a review of institutional documents from IFRC-supported CHW programs. We aimed to synthesize lessons learned from these programs and identify actionable strategies to improve program design and implementation. |
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| Methodology/Approach | We conducted a qualitative review of institutional documents from the IFRC and National Societies involved in CHW programming. Documents describing CHW program implementation across African contexts were identified and screened for relevance. Data relevant to implementation challenges, supports, and recommendations were extracted using a structured template. An inductive thematic analysis was then applied to generate cross‑cutting lessons, which were distilled into practice‑relevant insights for program improvement. |
| Results | Twenty-four documents were included in this study, representing CHW programs implemented in 15 countries across all regions of Africa. We identified nine interconnected lessons that can promote effective program implementation: 1) integrate CHW programming into existing health systems, 2) engage stakeholders across community, regional, and national levels, 3) cultivate community trust, 4) promote gender equity within the CHW workforce, 5) provide ongoing training and supportive supervision, 6) develop appropriate practice tools for CHWs, 7) foster CHW motivation, 8) ensure adequate and timely resource allocation, and 9) build adaptability into programs. |
| Discussion/Conclusion | Together, these lessons highlight practical pathways for strengthening CHW program implementation. Building on this synthesis, we propose three overarching policy recommendations for organizations/donors to target: prioritize multi-year, flexible financing along with intentional integration of CHW programs into health systems; adopt community-anchored design approaches that embed engagement and accountability throughout the program lifecycle; and promote continuous professional development to support CHW performance and retention. Systematically applying lessons from past experiences is essential for reinforcing equitable, community-based health service delivery across Africa. |
| Presenters and Affiliations | Jocelyne Labonté Canadian Red Cross & University of Ottawa Akalewold Gebremeskel Canadian Red Cross & University of Ottawa Ilja Ormel Canadian Red Cross Bhanu Pratap Maurya IFRC Salim Sohani Canadian Red Cross |
