In this title of the Rwanda’s evolving community health worker system: a qualitative assessment of client and provider perspectives, the author described the background and history of Community Health Workers in Rwanda (started in 1995 and currently have 3-4 members per village with total number of 60,000 CHWs) and their contribution in primary health care delivery, and also highlighted challenges they are facing and proposing some interventions to address barriers which CHWs are meeting in their work.
The author included the information on burden of disease mortality in the low income countries where by most of the under-5 mortalities in Africa were due to preventable infectious. Key information related to the status of maternal and children mortality were highlighted in this study where the author compared Rwanda with other countries on the performance of the key MDGs indicators on maternal mortality ratio estimated at 340 deaths per 100,000 live births in 2010 and a decrease of 59.5% was observed from 2000 to2010 and between 2000 and 2011,under-5 mortality rates decreased by 70.4%, In this study it was mentioned that the shortage of the skilled health professional is among the reasons that hinder the access to quality of healthcare services and interventions from the community health workers are key to reduce mortality among under 5 years due to the preventable infectious diseases.
In this study, the author had objective to evaluate the CHW system in Rwanda and identify factors and challenges that impacts the CHW system and can inform system improvements.
In this study, the context is based on the role and importance of CHWs in the healthcare service delivery considering the shortage of health professionals; barriers hindering the performance of CHWs were identified and author recommended key interventions which will impact on strengthening of the current CHW system and provide key guidance for the continuing evolution of the CHW system in Rwanda and this will contribute to the outcome of good health among the population