ASSESSMENT OF THE ENVIRONMENTAL FOUNDATION FOR COMMUNITY HEALTH WORKERS PROJECT IN RWANDA

Abstract

Countries across the globe are striving to achieve universal health coverage. There is a massive shortage of 4.25 million health workers in Africa and Asia, while the distribution of existing health workers within countries is inequitable (World Health Organization, 2006). The report recognized shortages of professional health workers as one of the key ingredients in the growing crisis of providing health services, particularly in low income countries. In Rwanda, the Economic Development and Poverty Reduction Strategy’ main objectives in the health sector are to maximize preventive health measures and build the capacity of Community Health Workers to provide quality and accessible health care services for the entire population. The overall objective of this study was to assess the environmental foundation for community health workers project in Rwanda. A descriptive research design and mixed approach were used. Quantitative data was collected from 354 Community Health Workers while qualitative data was collected from 10 supervisors. The survey was limited to 5 districts, selected based on their performance. First, the study revealed that Community Health Workers are largely dominated by women .The majority of Community Health Workers have less education completed their primary education and low capital. Secondly, the study showed that Project has national Policy and plans which influence the Community Health Workers performance, the implementation of mechanisms of performance based financing mechanisms through Community Health Workers cooperatives as a variable potentially influencing the performance and motivation of the Community Health Workers, and as a core strategy set in place to ensure the sustainability of the project. Thirdly, the study indicated that Community Health Workers Project face many challenges including geographical inaccessibility, insufficient materials, stock out of medicine, performance based financing coming at irregular rhythm and still not enough as an incentive for Community Health Workers, high responsibilities. Finally, the study recommended to the Government to improve the supply chain, to explore sustainable financial incentives for Community Health Workers and to consider social cultural belief during the recruitment of new Community Health Workers.