Exploring the experiences of community health workers during covid-19 pandemic in urban slums of Dhaka city

Abstract

Introduction: Community Health Workers (CHWs) are largely female who are employed by different private and public organizations with an aim to bridge the gap between formal healthcare and community, primarily working in rural and urban settings in Bangladesh. However the COVID-19 pandemic has posed unique challenges in urban slums of Dhaka because dwellers live in overcrowded spaces, lack access to WASH facilities and experience poverty which undermine COVID-19 prevention measures. In this context, CHWs play vital roles such as awareness, relief distribution and contact tracing to combat the spread of COVID-19. This study explored their experiences during the shutdown for service delivery organizations to recognize them as essential workforce. Method: The study drawn from 19 qualitative data transcripts from a larger research conducted by James P. Grant School of Public health at BRAC University which explored experiences of urban slums dwellers including CHWs during the COVID-19 shutdown in urban slums of Dhaka. Data was collected on phone from participants and coded inductively after organizing and categorizing according to themes and later placed on data matrix for easy visualization, analysis and interpretation. Findings: CHWs play key role in fighting COVID-19 in urban slums by linking the community and formal health care but they face challenges that include, disrupted personal and social lives, non-recognition and mistrust, increased workload, community expectations, poor remuneration and mental and emotional distress. Conclusion: The current COVID-19 situation has resulted to unprecedented challenges that affect the health and wellbeing of CHWs in urban slums in Dhaka, therefore government and service delivery organizations are urged to recognize CHWs as essential health workforce and implement feasible measures such as work shifts and leaves, improved remuneration, counseling support and regular training to enhance their performance. It is important to conduct additional exploratory research in other slums to generate more evidence.