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ORIGINAL ARTICLE
Open Access

Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study

Alyssa L. Davis, Lola Flomen, Jehan Ahmed, Djibrilla Maiga Arouna, Amos Asiedu, Maman Bacharou Badamassi, Ousmane Badolo, Moumouni Bonkoungou, Ciro Franco, Zachariah Jezman, Victoria Kalota, Beh Kamate, Daniel Koko, John Munthali, Raphael Ntumy, Patrick Sichalwe and Oumar Yattara
Global Health: Science and Practice June 2024, 12(3):e2400008; https://doi.org/10.9745/GHSP-D-24-00008
Alyssa L. Davis
aConsultant, PMI Impact Malaria, Washington, DC, USA.
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  • For correspondence: Alyssa.L.Davis@gmail.com
Lola Flomen
bConsultant, Population Services International, Washington, DC, USA.
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Jehan Ahmed
cPMI Impact Malaria, Washington, DC, USA.
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Djibrilla Maiga Arouna
dPMI Impact Malaria, Niamey, Niger.
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Amos Asiedu
ePMI Impact Malaria, Accra, Ghana.
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Maman Bacharou Badamassi
dPMI Impact Malaria, Niamey, Niger.
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Ousmane Badolo
fPMI Impact Malaria, Ouagadougou, Burkina Faso.
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Moumouni Bonkoungou
fPMI Impact Malaria, Ouagadougou, Burkina Faso.
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Ciro Franco
aConsultant, PMI Impact Malaria, Washington, DC, USA.
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Zachariah Jezman
gPMI Impact Malaria, Lilongwe, Malawi.
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Victoria Kalota
hPMI Impact Malaria, Lusaka, Zambia.
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Beh Kamate
iPMI Impact Malaria, Bamako, Mali.
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Daniel Koko
dPMI Impact Malaria, Niamey, Niger.
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John Munthali
gPMI Impact Malaria, Lilongwe, Malawi.
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Raphael Ntumy
ePMI Impact Malaria, Accra, Ghana.
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Patrick Sichalwe
hPMI Impact Malaria, Lusaka, Zambia.
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Oumar Yattara
iPMI Impact Malaria, Bamako, Mali.
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    TABLE 1.

    Key Informants Interviewed Across Seven sub-Saharan African Countries

    BeninBurkina FasoGhanaMalawiMaliNigerZambiaTotal
    Government23151013337
    Nongovernmental organization201220310
    United Nations agencies10001103
    Donor00110114
    Private-sector organization01000001
    Community health worker000823013
    Total543161518768
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    TABLE 2.

    Overview of Community Health Worker Financial Compensation Schemes in Seven sub-Saharan African Countries

    BeninBurkina FasoGhanaMalawiMaliNigerZambia
    Agents de Santé Communautaire QualifiéRelais CommunautaireAgents de Santé à Base CommunautaireCommunity Health OfficerCommunity Based VolunteerHealth Surveillance AssistantCommunity Health VolunteerAgents de Santé CommunautaireAgents de Santé CommunautaireRelais CommunautaireCommunity Health AssistantCommunity Based Volunteer
    Officially full time or part timeFull timePart timePart timeFull timePart timeFull timePart timeFull timeFull timePart timeFull timePart time
    Employed or volunteerEmployedVolunteerVolunteerEmployedVolunteerEmployedVolunteerEmployedEmployedVolunteerEmployedVolunteer
    Length of pre-service training and any degree requirements9th grade certificate or equivalent and paramedical training∼10 days, depending on partner priorities and disease burdens19 days2 year nursing degree + 2 weeks training∼5 days12 weeksVarying lengths depending on partner support22 days6 months2 weeks1 yearVarying lengths depending on partner support
    Financial compensation
     Salary,a US$∼300/month∼130-160/month∼175 – 280/month∼ 70/month∼80/month∼380/month
     Stipend,a US$∼75/month (performance based)∼30/month∼30/month<20 hours per week ∼30/month
     Incentive amountsStandardizedVariousStandardizedVariousStandardized
     Payment modeBank account transferMobile money transferMobile money transferBank account transferCashBank account transferCashVarious partner supported modesVarious partner supported modesMobile money transferBank account transferCash and Mobile credit
    Government supportedXXXXXXX
    Donor supportedXXXXXXXXXXX
    Minimum wage alignmentXXXXXXX
    Functions and services
     Community mobilizationXXXXXXXXXXXX
     Health promotionXXXXXXXXXXXX
     iCCM servicesXReferral onlyIf >5 km from health facilityFacility-based IMNCIReferral onlyXReferral onlyXIf >5 km from health facilityX
     Other servicesXOne Health PackageAd hoc campaignsXAd hoc campaignsXAd hoc campaignsXXXXAd hoc campaigns
    Catchment area
     CHW to population ratioAt least 1/arrondissement1/150–200 households1/1,000 people1/5,000 peopleUndefined1/1,000 peopleUndefined1/100–700 people1/10,000 people1/5,000 people1/health post1/250–500 households
     Individual communityXXXXBased on population densityXX
     Multiple communitiesXXXBased on population densityXX
    Health facility relationship
     Facility basedXXXXX
     Supervised by health facility staffXXXXXXXXXXXX
    • Abbreviations: CHW, community health worker; iCCM, integrated community case management; IMNCI, Integrated Management of Newborn and Child Illnesses.

    • ↵a Equivalent amounts calculated as of June 2023.

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Global Health: Science and Practice: 12 (3)
Global Health: Science and Practice
Vol. 12, No. 3
June 27, 2024
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Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study
Alyssa L. Davis, Lola Flomen, Jehan Ahmed, Djibrilla Maiga Arouna, Amos Asiedu, Maman Bacharou Badamassi, Ousmane Badolo, Moumouni Bonkoungou, Ciro Franco, Zachariah Jezman, Victoria Kalota, Beh Kamate, Daniel Koko, John Munthali, Raphael Ntumy, Patrick Sichalwe, Oumar Yattara
Global Health: Science and Practice Jun 2024, 12 (3) e2400008; DOI: 10.9745/GHSP-D-24-00008

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Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study
Alyssa L. Davis, Lola Flomen, Jehan Ahmed, Djibrilla Maiga Arouna, Amos Asiedu, Maman Bacharou Badamassi, Ousmane Badolo, Moumouni Bonkoungou, Ciro Franco, Zachariah Jezman, Victoria Kalota, Beh Kamate, Daniel Koko, John Munthali, Raphael Ntumy, Patrick Sichalwe, Oumar Yattara
Global Health: Science and Practice Jun 2024, 12 (3) e2400008; DOI: 10.9745/GHSP-D-24-00008
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