Perception of Community Health Workers on their Cooperative’s impact on the community Health Care Activities. Case of Cooperatives in BUGESERA and KICUKIRO Districts

Abstract

Background: Community health workers (CHWs) play important roles in primary health care delivery, particularly in settings of health workforce shortages. However, little is known about CHWs’ perceptions of difficult or motivation that should be generated by their income generating activities implemented under CHW’s Cooperatives. Actually, our country Rwanda, faces a significant gap in human resources for health, the Ministry of Health expanded its community health programme beginning in 2007, eventually placing 3 trained CHWs in every village in the country by 2009. The aim of this study was to find out from the CHWs’ perspective, the impact their cooperatives have on the services they render to the community; we really want to know if CHW’s Cooperative is a motivator and a builder or if it is a distraction and a destroyer factor. Method: This study was qualitative, a case study design in nature capturing opinions and perceptions of the community health workers. The data was collected using focus group discussions (FGDs) with CHWs from BUGESERA and KICUKIRO districts with two sectors each district; one identified as a rural area and other qualified as urban one. Those sectors were selected conveniently making a total sample of four sectors in the sample (Nyamata and Juru from Bugesera district, Gikondo and Kanombe sectors in Kicukiro district). From the four sectors, the researcher selected respondents to participate in four focus group discussions two from each district with eight members each group making the final total number of respondents equal to 32 persons (18 female and 14 male).All participants have been informed about the study and accepted to participate. Data was recorded using a digital voice recorder and expanded at the end of each day during its transcription in Kinyarwanda. The thematic content analysis based to different dimensions of our study. Results: the community health workers find no issues in the management of their cooperatives. The trust they hold in the leadership, local authorities and the ministry of health is actually the basis of this perspective. It is critically important to note that sustainability of cooperatives of community health workers greatly depends on the commitment and continued follow up of local leadership and the ministry of health.