Improving local health through community health workers in Cambodia: challenges and solutions
Abstract Background Volunteer community health workers (CHWs) are an important link between the public health system and the community. The ‘Community Participation Policy for Health’ in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Human Resources for Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12960-017-0262-8 |
| _version_ | 1818244031418728448 |
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| author | Kim Ozano Padam Simkhada Khem Thann Rose Khatri |
| author_facet | Kim Ozano Padam Simkhada Khem Thann Rose Khatri |
| author_sort | Kim Ozano |
| collection | DOAJ |
| description | Abstract Background Volunteer community health workers (CHWs) are an important link between the public health system and the community. The ‘Community Participation Policy for Health’ in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Methods Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Results Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. Conclusions The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently, the health of community members. CHWs presented with the opportunity to share learning and develop ideas in a supportive environment would benefit health initiatives. |
| first_indexed | 2024-12-12T14:10:33Z |
| format | Article |
| id | doaj.art-420d068da2534b79b7b190bb9e5c5f30 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-12-12T14:10:33Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj.art-420d068da2534b79b7b190bb9e5c5f302022-12-22T00:22:05ZengBMCHuman Resources for Health1478-44912018-01-0116111210.1186/s12960-017-0262-8Improving local health through community health workers in Cambodia: challenges and solutionsKim Ozano0Padam Simkhada1Khem Thann2Rose Khatri3Public Health Institute, Liverpool John Moores UniversityPublic Health Institute, Liverpool John Moores UniversityLouvain CooperationPublic Health Institute, Liverpool John Moores UniversityAbstract Background Volunteer community health workers (CHWs) are an important link between the public health system and the community. The ‘Community Participation Policy for Health’ in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Methods Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Results Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. Conclusions The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently, the health of community members. CHWs presented with the opportunity to share learning and develop ideas in a supportive environment would benefit health initiatives.http://link.springer.com/article/10.1186/s12960-017-0262-8Community health workersCambodiaHealth promotionHealth systemsQualitative research |
| spellingShingle | Kim Ozano Padam Simkhada Khem Thann Rose Khatri Improving local health through community health workers in Cambodia: challenges and solutions Human Resources for Health Community health workers Cambodia Health promotion Health systems Qualitative research |
| title | Improving local health through community health workers in Cambodia: challenges and solutions |
| title_full | Improving local health through community health workers in Cambodia: challenges and solutions |
| title_fullStr | Improving local health through community health workers in Cambodia: challenges and solutions |
| title_full_unstemmed | Improving local health through community health workers in Cambodia: challenges and solutions |
| title_short | Improving local health through community health workers in Cambodia: challenges and solutions |
| title_sort | improving local health through community health workers in cambodia challenges and solutions |
| topic | Community health workers Cambodia Health promotion Health systems Qualitative research |
| url | http://link.springer.com/article/10.1186/s12960-017-0262-8 |
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