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
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
Minor concerns regarding methodological limitations, relevance, coherence and adequacy.
2. Some unsalaried lay health workers expressed a strong wish for regular payment.
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 and moderate concerns regarding adequacy of data.