Exploring the Liaising Role of Community Health Workers in the Bordering Region of India-Bangladesh: A Mix-Method Approach

Abstract

The Community Health Workers (CHWs) function as liaisons between communities and public health systems through educating, informing, and creating awareness about healthy lives and healthcare facilities. Existing studies have emphasized the importance of CHWs for Universal Health Coverage (UHC), but overlooked the challenges they face during delivery of the services. This study seeks to assess the multiple roles of health workers, the challenges and barriers they face during the delivery of services in the peripheral region of India. The study triangulates the findings of qualitative interviews with quantitative findings. 16 CHWs were interviewed in the three districts of Assam adjacent to the Indo-Bangladesh border areas. Besides, a cross-sectional survey with 355 women who gave birth in the last year or were pregnant (during the time of the survey) was conducted to substantiate the qualitative findings. The in-depth interviews broadly focus on the daily activities of the workers, which includes services towards reproductive and child healthcare, and vaccination and immunization services. The mix-method study analysis included thematic framework approach followed by the interpretation and exerts from the in-depth interviews and substantiated by the descriptive statistics. The analysis reveals that majority of the respondents rely on the services of the CHWs from minor ailments to registering for pregnancy, assistance with financial services provided by the government, assisting during pregnancy, arranging transportation for the hospital, assisting with abortion, assisting child immunization, educating about a healthy lifestyle. The significant challenges that the workers face are the incentive and remuneration structure, along with the inadequate supply of medical equipment and medicines. The socio-economic condition of the community, as well as the geographical terrain, adds more to the challenges and barriers. The health administrators must enhance the working conditions of the CHWs through restructuring the incentive pattern and easy access to health deliverables.