The Role of Community Health Workers in Bridging the Primary Health Care Gap: A Case of Tiko Health District, Cameroon
Abstract:
Community Health Workers (CHWs) play a
central role in improving access to primary health care (PHC), particularly in
low- and middle-income settings where shortages of trained personnel persist.
In Cameroon, the Community-Directed Intervention (CDI) approach has been
adopted to support community-based service delivery. However, evidence on the
extent of CHWs’ contribution to bridging gaps in PHC remains limited. This
study assessed the role of CHWs in the Tiko Health District. A convergent
mixed-methods cross-sectional study was conducted among 464 participants,
including household heads, CHWs, and key stakeholders. Quantitative data were analyzed
using IBM SPSS version 27, while qualitative data from key informant interviews
were analyzed thematically. Statistical significance was set at p < 0.05.
Awareness of CHWs was high (96.9%), and 78.1% of respondents reported having
received CHW services, while 97.6% indicated that CHWs were accessible when
needed. Overall satisfaction was reported by 81.4% of participants. There was a
significant positive correlation between awareness and utilization of CHW
services (r = 0.315, p < 0.001). CHWs contributed mainly to immunization
mobilization (30.4%), referrals (28.9%), and health education (27.9%), whereas
their involvement in maternal and child health (9.9%) and disease surveillance
(8.9%) was lower. Although most CHWs reported receiving supervision, training,
and incentives, important gaps were identified in transport support,
availability of essential medicines, and reporting tools. Support factors were
significantly associated with service utilization (p < 0.001). CHWs
contribute meaningfully to improving access to PHC in the Tiko Health District.
Addressing gaps in logistics, supervision, and system support is essential to strengthening
their effectiveness and long-term sustainability.
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