Objective: To identify, appraise and synthesise qualitative research evidence on the barriers and facilitators to the implementation of lay health worker programmes for maternal and child health Perspective: Experiences and attitudes of stakeholders about lay health worker programmes in any country Included programmes: Programmes that were delivered in a primary or community healthcare setting; that intend to improve maternal or child health; and that had used any type of lay health worker, including community health workers, village health workers, birth attendants, peer counsellors, nutrition workers and home visitors | |||
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Summary of review finding | Studies contributing to the review finding | CERQual assessment of confidence in the evidence | Explanation of CERQual assessment |
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 | Moderate | Minor concerns regarding methodological limitations, relevance, coherence and adequacy. |
2. Some unsalaried lay health workers expressed a strong wish for regular payment. | 5, 13 | Low | 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 | Moderate methodological limitations and moderate concerns regarding adequacy of data. |