AIDS
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Multicenter Study
Community health workers in health systems strengthening: a qualitative evaluation from rural Haiti.
Haiti is among the countries facing serious shortages in human resources for healthcare. In rural Haiti, the need for daily, long-term adherence to medication for HIV and TB was initially the driving factor for recruitment of community health workers (CHW) during scale-up of HIV services. Their role became broader over time. This qualitative study evaluated the role of CHW in the health system as a whole in both HIV and non-HIV-related services in rural Haiti and investigated the challenges and facilitating factors for their work. ⋯ CHW initially hired for HIV care represent an important part of the health system in rural Haiti in both HIV-related and primary healthcare services. CHW programmes have important potential for building capacity in the health workforce and thereby contributing to strengthening of the health system as a whole. Attention must be paid to adequate remuneration, training and provision of materials.