Community health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a synthesis of key challenges and considerations that can inform efforts to reduce attrition and improve the sustainability of community health volunteers in Africa. This scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews checklist to achieve the objectives. A comprehensive search of six databases returned 2140 sources. After screening, 31 peer-reviewed studies were selected for final review. Analytical themes were generated based on the reviewers’ extraction of article data into descriptive themes using an inductive approach. In reviewing community health volunteers’ accounts of providing health services, five key challenges become apparent. These are: (1) challenges balancing work responsibilities with family obligations; (2) resource limitations; (3) exposure to stigma and harassment; (4) gendered benefits and risks; and (5) health-system level challenges. This scoping review highlights the extent of challenges community health volunteers must navigate to provide services in communities. Sustained commitment at the national and international level to understand the lived experiences of community health volunteers and mitigate common stressors these health actors face could improve their performance and inform future programs.

ObjectivesTo ask all clinical, administrative and support staff affiliated with a large network of healthcare facilities to identify the conditions that they consider as non-negotiable for their own deaths to be regarded as good.MethodsAll 3495 staff of a healthcare network were asked to rank 10 conditions according to how non-negotiable they would be for themselves during their final 3 months or few hours for their own deaths to be considered as good. They were also asked about whether they had thought about their own death in the last 3 months, if they had a will, believed in God, and in the possibility of a good death, and the intensity of their fear of death.Results2971 (85%) completed the survey. Most were female (79%) and clinical staff (65%). 93% believed in God, 60% had thought about their death recently, 33% had an intense fear of death, and 4% had a will. 64% considered a good death possible. Participants ranked dying at a preferred place, emotional support from family and friends and relief from physical symptoms as their top priorities. The lowest ranked conditions were (from the bottom) relief from psychological distress, performance of rituals and the right to terminate life. There were no statistically significant differences across genders or individual occupational groups.ConclusionMost of conditions for a good death of interest to healthcare professionals could be provided without sophisticated medical infrastructure or specialised knowledge, opening the door for new support services to make it possible for everyone, anywhere.

Community health volunteers (CHVs) are considered a vital part of the community health structure in Africa. Globally, community health volunteers are widely recognized as vital components in the health system of low- and middle-income countries, enabling the extension of national and sub-national capacities for diagnosis, treatment, monitoring, and health promotion programs. Despite this vital role in the health system, very little is known about the CHVs day-to-day lived experiences providing services in communities and supporting other health workers. The purpose of this scoping review is to better understand the experiences and challenges of a community health volunteer in Africa. More specifically, drawing on the community health volunteers’ accounts of their experiences as reported in the literature to date, this review aims to identify critical factors or conditions that represent challenges to community health volunteers work in Africa. Advancing an understanding of community health volunteers experiences and challenges can inform governments and programs on how best to support community health volunteers both generally and specifically with respect to performance expectations within community-based healthcare delivery or health behaviour change and promotion programs.

Background Community health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in the health system, very little is known about the community health volunteers day-to-day lived experiences providing services in communities and supporting other health workers. ObjectiveThis scoping review aims to better understand the experiences and challenges of community health volunteers in Africa. Drawing on the community health volunteers’ accounts of their experiences reported in the literature, this review aims to identify critical factors that could, if filled, advance understanding of this under-considered group crucial to healthcare delivery, reduce attrition of, and improve sustainability of community health volunteers in Africa. MethodsThis scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews checklist to achieve the objectives. A comprehensive search of six databases returned 2140 studies. After screening, 31 studies were selected for final review and extraction. Using an inductive approach, analytical themes were generated based on the reviewers’ interpretative construct of the descriptive themes.ResultsFindings highlight the challenges and difficulties community health volunteers often deal with while providing services. Critical themes generated in this review indicate that a lack of standardization of the role and remuneration of community health volunteers within health systems, balancing work responsibilities with family obligations and financial and logistical issues are common challenges that affect community health volunteers’ experiences. Additionally, the review found that community health volunteers will also face stigma and harassment from other health workers and communities. However, there seem to be potential gendered benefits and risks in the role of female community health workers.ConclusionsThis scoping review highlights the scope of challenges community health volunteers must navigate to provide services in communities. Sustained commitment at the national and international level to understand the lived experiences of community health volunteers would improve their performance and inform future programs.

This article critically examines an HIV/AIDS development and research project in Mwanza, Tanzania. A group of women produce a type of probiotic yoghurt that has provided evidence of lowering the incidence of HIV infection. The yoghurt is consumed by the women, their family members, and local citizens living with HIV/AIDS; surplus is sold within the community. While the project's multi-partner, multi-disciplinary composition allows for varied expertise and insights, it also requires open and collaborative dialogue. This article discusses the project's challenges, positive outcomes, and some of the socio-cultural issues that need to be addressed if it expands in size and/or scope.