The Perceived Role and Value of Community Health Workers in Addressing Family Planning Uptake in a Rural District in Ghana

Abstract

Community health workers (CHW) play an important role in providing healthcare services in resource-deprived settings. In 2016, Ghana Health Services initiated a national CHW program to expand health services to rural populations. The aim of this study was to explore the perceived role and value of CHWs in the provision of family planning services in Amansie West district in Ghana. This mixed-method study included household surveys with 281 women in the community age 18-49, and in-depth interviews (IDIs) with a subset of 33 participants and with 30 CHWs. The survey included questions on family planning uptake and CHW interactions, while IDIs explored opinions on CHWs’ role and value in delivery of family planning. Surveys were analyzed using R studio. IDIs were transcribed, coded in NVivo, and analyzed for emergent themes. Overall, 57% of women reported that they knew a CHW in their area and 34% of them reported having regular contact. Participants identified the CHWs’ roles as providing family planning as part of a broader healthcare package through household visits and referrals to government health services. Regarding the value of CHWs in delivering family planning, emerging themes included confidentiality, accessibility, and comfort. Participants recommended the need for an enlarged CHW workforce with better commodities and programmatic support. The findings from this study suggest that both women and CHWs perceive that CHWs play a valuable role in delivering family planning, by serving as a bridge between the community and clinics. In rural communities where resources are scarce, CHWs are an invaluable part of the broader healthcare system.