The Experiences and Challenges of Community Health Volunteers as Agents for Behaviour Change programming in Sub-Sahara Africa: A scoping review protocol

AbstractBackground Community health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in the health system, very little is known about the community health volunteers day-to-day lived experiences providing services in communities and supporting other health workers. ObjectiveThis scoping review aims to better understand the experiences and challenges of community health volunteers in Africa. Drawing on the community health volunteers’ accounts of their experiences reported in the literature, this review aims to identify critical factors that could, if filled, advance understanding of this under-considered group crucial to healthcare delivery, reduce attrition of, and improve sustainability of community health volunteers in Africa. MethodsThis scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews checklist to achieve the objectives. A comprehensive search of six databases returned 2140 studies. After screening, 31 studies were selected for final review and extraction. Using an inductive approach, analytical themes were generated based on the reviewers’ interpretative construct of the descriptive themes.ResultsFindings highlight the challenges and difficulties community health volunteers often deal with while providing services. Critical themes generated in this review indicate that a lack of standardization of the role and remuneration of community health volunteers within health systems, balancing work responsibilities with family obligations and financial and logistical issues are common challenges that affect community health volunteers’ experiences. Additionally, the review found that community health volunteers will also face stigma and harassment from other health workers and communities. However, there seem to be potential gendered benefits and risks in the role of female community health workers.ConclusionsThis scoping review highlights the scope of challenges community health volunteers must navigate to provide services in communities. Sustained commitment at the national and international level to understand the lived experiences of community health volunteers would improve their performance and inform future programs.