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Table 2 Examples of stressors and challenges faced by CHWs

From: Community health workers at the dawn of a new era: 5. Roles and tasks

Type of CHW

Stressors

Lady health workers (Pakistan) [29]

Lack of adequate training to communicate effectively with families

Lack of skills to perform the tasks required

Low socioeconomic status (can cause lack of respect and harassment)

Need to travel long distances by foot

Stock-outs of medical supplies

Low salary

Lack of a career structure

ASHA workers (India) [30]

Violent attacks by men

Lack of respect from superiors due to families’ standing and level of education

Low salary (this has psychosocial implications such as feeling alienated and undervalued for the disproportionate burden they now bear, particularly in light of their new role in India’s battle against COVID-19) [30]

HEWs (Ethiopia) [31]

Lack of community trust in the services and the products HEWs provide

Village health team members (Uganda) [32,33,34]

Lack of trust from other health-care providers who view CHWs as not appropriately trained and a government ploy for control

Conflicts with higher-level staff

Stock-outs of medicines and equipment

Lack of respect from community members and government officials (mistrust and stigma can lead to emotional trauma and depressive symptoms, as seen during the Ebola and Marburg virus outbreaks)

CHWs (Tanzania) [35]

Stock-outs of medicines and supplies

CHEWs (Nigeria) [36]

Lack of training for the reality of the job

Health surveillance assistants (Malawi) [37]

Lack of adequate training

Inadequate supervision

Work overload due to the extensive needs of the community

Low pay

Women’s Development Army volunteers (Ethiopia) [38]

Psychosocial challenges, including becoming the subject of gossip

CHWs in Papua New Guinea [39]

Young female CHWs feel unsafe and afraid because of abuse from young men, violent assaults, and accusations

  1. ASHA accredited social health activist, HEWs health extension workers, CHEWs community health extension workers