This literature review was produced to inform how social and behaviour change communication (SBCC) programmes can contribute to improving services provided by community health workers (CHWs) and strengthen their ability to effectively deliver quality health care to community members. Produced as part of the Health Communication Capacity Collaborative (HC3) project, the literature review examines barriers and facilitating factors for CHWs in three areas: knowledge and competency, structural and contextual barriers (systemic and environmental factors), and motivational barriers (such as social norms and attitudes that effect CHWs willingness to provide services). Findings revealed that “CHWs face significant barriers, ranging from lack of materials and high workloads to ingrained attitudes and insufficient training.” The report shares results and recommendations that can be used to anticipate and respond to potential barriers and promote facilitators to service provision through SBCC programmes for CHWs.
Based on a literature review, which included both peer-reviewed journals and grey literature on the topic of CHWs (with a particular focus on CHWs abilities, performance and attitudes), limited to resources published in the last 10 years focussing on middle- and lower-income countries, the report outlines a number of key findings.
The report concludes that “while identifying and understanding barriers can assist in the design and implementation of SBCC programs, additional research is needed to evaluate the actual impact of SBCC programs in overcoming these barriers. Some knowledge and attitudinal barriers may be easily addressed through communication strategies, however, more serious systemic barriers may prove more challenging to resolve.”