The role of community health workers in reducing child mortality in Rwanda: A case of Busogo Sector (2014-2019)

Abstract

The general objective of this study was to explore the role of Community Health Workers (CHWs) in reducing child mortality in Rwanda. The specific objectives of the study were (1) to explore the role of CHWs in ensuring better health of children in Busogo Sector, (2) to find out the extent to which CHWs are effective in providing services aimed at reducing child mortality in Busogo Sector and (3) to identify the challenges facing CHWs in providing services aimed at reducing child mortality in Busogo Sector. The study adopted a qualitative research design. The target population was composed of 85 individuals composed of CHWs in Busogo Sector, Sector social affairs, CHW supervisors, and executive secretaries of cells and a sample of 48 respondents selected using convenience and purposive sampling techniques. Data were collected using interviews and Focus group discussions (FGDs). Data were analyzed by thematic analysis. Findings showed that CHWs play different roles in bettering child health in Busogo sector by the provision of health promotion and preventive care to pregnant women and children, enhanced uptake of preventive measures like the promotion of a clean home environment and adequate sanitation, diagnosis and treatment of children with non-severe pneumonia and fever and hence reduce the risk of death among children. However, CHWs are constrained by skills gap translated by lack of knowledge on some health related topics, lack of proper supervision, large catchment and coverage area and work overloads and lack of adequate tools and equipment. The study was underpinned by the Life Course Theory and Role development Theory which reflects that care given to children at birth and to their mothers before birth, affect their immediate wellbeing and have an impact on their health and development in later years (Fine et al., 2010) as CHWs provide care not only to pregnant women to enable the child get abilities to live off well after birth while the Role Development theory advocate that CHWs’ roles were developed and attributed to them to enable them participate in enhancing better health of the population they serve. Hence, the creation of role of CHWs enabled them to provide care to mothers which impact on the wellbeing of children in the later age.