Table 4 CERQual Qualitative Evidence Profile—Example B

1. While regular salaries were not part of many programmes, other monetary and non-monetary incentives, including payment to cover out-of-pocket expenses and “work tools” such as bicycles, uniforms or identity badges, were greatly appreciated by lay health workers.

2, 5, 11, 12, 22, 29

Minor methodological limitations

(five studies with minor and one study with moderate methodological limitations (unclear recruitment and sampling strategy, no reflexivity))

Minor concerns about coherence

(some concerns about the fit between the data from primary studies and the review finding)

Minor concerns about adequacy

(six studies that together offered moderately rich data)

Minor concerns about relevance

(studies of lay health worker programmes from three continents and including a fairly wide range of different clients and health issues)

Moderate

confidence

Minor concerns regarding methodological limitations, relevance, coherence and adequacy.

2. Some unsalaried lay health workers expressed a strong wish for regular payment.

5, 13

Minor methodological limitations

(both studies had minor methodological limitations (unclear sampling strategy, no reflexivity))

Minor concerns about coherence

(some concerns about the fit between the data from primary studies and the review finding)

Serious concerns about adequacy

(only two studies, both offering thin data)

Moderate concerns about relevance

(partial relevance as the studies were from only two settings, both of which were in Africa)

Low confidence

Moderate concerns regarding relevance and serious concerns regarding adequacy of data.

3. Lay health workers, particularly those working in urban settings, reported difficulties maintaining personal safety when working in dangerous settings or at night.

3, 15, 16, 25, 31

Moderate methodological limitations

(2 studies with minor methodological limitations, 2 studies with moderate methodological limitations (unclear ethical considerations and unclear statement of research aims)

Minor concerns about coherence

(some concerns about the fit between the data from primary studies and the review finding)

Moderate concerns about adequacy

(studies offered very thin data)

Minor concerns about relevance

(studies of lay health worker programmes across three continents but for a limited range of health issues)

Moderate confidence

Moderate methodological limitations and moderate concerns regarding adequacy of data.