Community Health Volunteers’ Experiences and Relationships with Community and Health Systems: A case study of a TB program in Zambia

Background: The recent global push to integrate community health volunteer (CHVs) programs into formal health system in Low- and Middle-Income Countries (LMIC). In Zambia, informal CHVs have supported primary health care alongside formal Community Health Workers called Community Health Assistants (CHAs) for decade. CHVs in TB program are essential, particularly in case finding, treatment adherence support, and community TB awareness, however, little is known about CHWs experiences of their interactions and relationships with diverse stakeholders, and what support they need to work most effectively. Objective: This sociological research aims to contribute to a broader understanding of CHV relationships within an NGO-supported TB program in Lusaka, Zambia. It will explore how Treatment Supporters’ relationships can inform how to best support CHVs to strengthen community’s engagement in prevention and management of tuberculosis within the integrated health system.

Methodology: Constructionism will guide my study. A Qualitative Case Study approach will be used to examine the experiences of TB volunteers in this NGO-supported project. Data will be collected through in-depth interviews with volunteers, healthcare workers, NGO staff, and community members, focus group with volunteers, observation, and documents. Working across language, interviews will be recorded and transcribed and translated. Interviews will be analysed thematically to understand how CHWs interactions with the stakeholders shape their relationships with community and health system. Expected Outcome: This research will contribute to the development of practical knowledge about CHWs’ relationships and bridging roles through interactions with the community, health system, and other key TB stakeholders.