Aschenaki Z. Kea

TL;DR: Policy-makers and programme managers should take into account the broader context and adjust CHW programmes so that they trigger mechanisms that generate trusting relationships between CHWs, communities and other actors in the health system to contribute to enabling CHWs to perform well and responding to the opportunities offered by their unique intermediary position.

TL;DR: Health extension workers in Ethiopia can be constrained as a result of inadequate support systems, lack of trust, communication and dialogue and differing expectations, so clearly defined roles at all levels and standardized support, monitoring and accountability, referral, supervision and training could improve dialogue and trust between HEWs and actors from the community and health sector.

TL;DR: Use of maternal health services at the PHCU level in Sidama zone is influenced by complex factors within the community and health system, and PHCUs should continue to implement awareness creation activities to improve knowledge of the community on complications of pregnancy and benefits of maternal healthcare.

TL;DR: There is potential for integrating supportive group supervision models in CHW programmes and a combination of group with individual or peer supervision, preferably accompanied with methods that assess CHW performance and corresponding feedback systems, could yield improved motivation and performance.

TL;DR: MHealth has the potential to improve community health service delivery and the experiences of HEWs who deliver it, but the introduction of this technology requires exploration to ensure that new gender and power relations transform, rather than disadvantage, women.