Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone

Introduction: Community health workers (CHWs) play an integral role in Sierra Leone's health systems strengthening efforts. Our goal was to understand CHWs' experiences of providing immunization and malaria prevention services in urban settings and explore opportunities to optimize their c...

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Autores principales:	Atsuyoshi Ishizumi, Roberta Sutton, Anthony Mansaray, Lauren Parmley, Oliver Eleeza, Shibani Kulkarni, Tom Sesay, Laura Conklin, Aaron S. Wallace, Adewale Akinjeji, Mame Toure, Maria Lahuerta, Mohamed F. Jalloh
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	community health worker (CHW) Sierra Leone immunization malaria urban slum Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/725c74d5ddd946fb9baaec8190c43e16
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spelling	oai:doaj.org-article:725c74d5ddd946fb9baaec8190c43e162021-12-02T06:35:01ZCommunity Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone2296-256510.3389/fpubh.2021.767200https://doaj.org/article/725c74d5ddd946fb9baaec8190c43e162021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpubh.2021.767200/fullhttps://doaj.org/toc/2296-2565Introduction: Community health workers (CHWs) play an integral role in Sierra Leone's health systems strengthening efforts. Our goal was to understand CHWs' experiences of providing immunization and malaria prevention services in urban settings and explore opportunities to optimize their contributions to these services.Methods: In 2018, we conducted an exploratory qualitative assessment in the Western Area Urban district, which covers most of the capital city of Freetown. We purposively selected diverse health facilities (i.e., type, ownership, setting) and recruited CHWs through their supervisors. We conducted eight focus group discussions (FGD) with CHWs, which were audio-recorded. The topics explored included participants' background, responsibilities and priorities of urban CHWs, sources of motivation at work, barriers to CHWs' immunization and malaria prevention activities, and strategies used to address these barriers. The local research team transcribed and translated FGDs into English; then we used qualitative content analysis to identify themes.Results: Four themes emerged from the qualitative content analysis: (1) pride, compassion, recognition, and personal benefits are important motivating factors to keep working as CHWs; (2) diverse health responsibilities and competing priorities result in overburdening of CHWs; (3) health system- and community-level barriers negatively affect CHWs' activities and motivation; (4) CHWs use context-specific strategies to address challenges in their work but require further support.Conclusion: Focused support for CHWs is needed to optimize their contributions to immunization and malaria prevention activities. Such interventions should be coupled with systems-level efforts to address the structural barriers that negatively affect CHWs' overall work and motivation, such as the shortage of work supplies and the lack of promised financial support.Atsuyoshi IshizumiRoberta SuttonAnthony MansarayLauren ParmleyOliver EleezaShibani KulkarniTom SesayLaura ConklinAaron S. WallaceAdewale AkinjejiMame ToureMaria LahuertaMaria LahuertaMohamed F. JallohFrontiers Media S.A.articlecommunity health worker (CHW)Sierra Leoneimmunizationmalariaurban slumPublic aspects of medicineRA1-1270ENFrontiers in Public Health, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	community health worker (CHW) Sierra Leone immunization malaria urban slum Public aspects of medicine RA1-1270
spellingShingle	community health worker (CHW) Sierra Leone immunization malaria urban slum Public aspects of medicine RA1-1270 Atsuyoshi Ishizumi Roberta Sutton Anthony Mansaray Lauren Parmley Oliver Eleeza Shibani Kulkarni Tom Sesay Laura Conklin Aaron S. Wallace Adewale Akinjeji Mame Toure Maria Lahuerta Maria Lahuerta Mohamed F. Jalloh Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone
description	Introduction: Community health workers (CHWs) play an integral role in Sierra Leone's health systems strengthening efforts. Our goal was to understand CHWs' experiences of providing immunization and malaria prevention services in urban settings and explore opportunities to optimize their contributions to these services.Methods: In 2018, we conducted an exploratory qualitative assessment in the Western Area Urban district, which covers most of the capital city of Freetown. We purposively selected diverse health facilities (i.e., type, ownership, setting) and recruited CHWs through their supervisors. We conducted eight focus group discussions (FGD) with CHWs, which were audio-recorded. The topics explored included participants' background, responsibilities and priorities of urban CHWs, sources of motivation at work, barriers to CHWs' immunization and malaria prevention activities, and strategies used to address these barriers. The local research team transcribed and translated FGDs into English; then we used qualitative content analysis to identify themes.Results: Four themes emerged from the qualitative content analysis: (1) pride, compassion, recognition, and personal benefits are important motivating factors to keep working as CHWs; (2) diverse health responsibilities and competing priorities result in overburdening of CHWs; (3) health system- and community-level barriers negatively affect CHWs' activities and motivation; (4) CHWs use context-specific strategies to address challenges in their work but require further support.Conclusion: Focused support for CHWs is needed to optimize their contributions to immunization and malaria prevention activities. Such interventions should be coupled with systems-level efforts to address the structural barriers that negatively affect CHWs' overall work and motivation, such as the shortage of work supplies and the lack of promised financial support.
format	article
author	Atsuyoshi Ishizumi Roberta Sutton Anthony Mansaray Lauren Parmley Oliver Eleeza Shibani Kulkarni Tom Sesay Laura Conklin Aaron S. Wallace Adewale Akinjeji Mame Toure Maria Lahuerta Maria Lahuerta Mohamed F. Jalloh
author_facet	Atsuyoshi Ishizumi Roberta Sutton Anthony Mansaray Lauren Parmley Oliver Eleeza Shibani Kulkarni Tom Sesay Laura Conklin Aaron S. Wallace Adewale Akinjeji Mame Toure Maria Lahuerta Maria Lahuerta Mohamed F. Jalloh
author_sort	Atsuyoshi Ishizumi
title	Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone
title_short	Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone
title_full	Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone
title_fullStr	Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone
title_full_unstemmed	Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone
title_sort	community health workers' experiences in strengthening the uptake of childhood immunization and malaria prevention services in urban sierra leone
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/725c74d5ddd946fb9baaec8190c43e16
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Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone

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