Frontline health workers are often the first and only link to essential health services for millions of people worldwide, particularly during humanitarian crises.
In Haiti, a country plagued by disruptive shocks including political transitions, natural disasters, and disease outbreaks for over two decades, community health workers provide reproductive, maternal, newborn, and child health in addition to primary health care such as health education and social support.
Despite this essential work, there is limited understanding of the lived experience of community health workers. During crises, frontline health workers often face vulnerability and risk including inadequate personal protective equipment, supervision, and mental health support.
Population Council researchers in partnership with Zanmi Lasante conducted a qualitative study to analyze the experiences of community health workers. The research was conducted as part of our Frontline Health project.
We documented different shocks and community health policies, guidelines, and strategies implemented over the last fifteen years in Haiti and conducted interviews with policy and program stakeholders, community health workers, supervisors, and auxiliary nurses.
Our analysis included a data-driven theory of how external shocks interact with policy and health systems to affect the functioning and resilience of community health workers. We also considered mitigating factors such as policy, financing, governance, or parallel health systems.
The study confirms the importance of community health systems in maintaining primary health care for a country in protracted crises. It outlines an approach for exploring and strengthening the resilience of community health workers in complex humanitarian settings globally.