Community Health Workers: Delivering Impact from Classroom to Community

Christine Nyinawintore is one of of 2284 CHWs in Burera District, UGHE’s home in Northern Province Rwanda, supporting in COVID19 vaccination campaign.

Community Health Workers (CHWs) are at the centre of community mobilization for healthy behaviours to prevent the spread of COVID-19. They make up the largest single group involved in health delivery in Rwanda, playing a vital role in providing village-level health care that focuses on maternal and child health, control of infectious diseases, health education, to name a few of their wide-ranging responsibilities. 

Christine Nyinawintore is one of 2284 CHWs in Burera District, UGHE’s home in Northern Province Rwanda, and one of the CHWs trained on Community-Based Education (CBE) teaching methodology by UGHE’s Community Health and Social Medicine department. For twelve years now, Christine has been helping to drive a range of community health programs in the area in alignment with national health priorities. In the last few months, her role has extended to support Rwanda’s  COVID19 vaccination campaign, and her innate community knowledge and trust has been invaluable.

UGHE has trained 36 facility healthcare providers and 72 CHWs including Christine on teaching methodologies that help them to conduct effective community outreach. Pictured here: UGHE’s Community Based Education Orientation takes place on Butaro Campus in 2019.

On receipt of robust training to support her work, she has closely collaborated with health centers to identify community members with underlying conditions, including those with chronic diseases that might be eligible for the vaccine. Rwanda’s vaccine campaign has been focussed on equity from its onset, with frontline and essential workers, those vulnerable to the virus, and people living in crowded settings such as refugees and prison populations within the 3 million priority recipients of the allocation. “During this vaccination campaign, we are helping healthcare professionals identify priority groups including people older than 65 years or with underlying health conditions in our village.” explains Christine.

Denys Ndangurura, UGHE’s Coordinator in the Department of Community Health and Social Medicine trains a group of Butaro Community Health Workers on Community Based Education teaching methodology in 2020. 

CHWs are not just supporting in the rollout of the Covid-19 vaccine campaign, but also playing a crucial role in building trust and reducing vaccine hesitancy which, in some other parts of the world, is a significant barrier to vaccine uptake and roll-out. Working at household level, and  having been prepared and equipped with basic knowledge before the outbreak, Christine responds to the questions from community members around Covid-19 transmission, and explains the importance of getting vaccinated. This takes place alongside continuous efforts to mobilize the community to take up, and spread the word about preventive measures to curb the COVID transmission.

A total of 24 Community Health Workers attended UGHE’s interactive training session on Butaro Campus in 2019.

Rwanda has also been hailed internationally and not just in Africa, as a Covid-19 response success story owing to its rapid preparation and deployment of rigorous preventive measures and a smooth vaccination campaign. Over the last four weeks, approximately 350,000 people in Rwanda have at least received the first dose of the Covid-19 vaccination and many are currently taking the second jab. The country aims to vaccinate 30% of the population by the end of 2021 and 60% by the end of 2022. 

UGHE organizes workshops for community health workers like Christine on how to deliver constructive feedback. Pictured: UGHE’s Denys Ndangurura with CHWs at Rusasa Health Center of Burera District

A total of 75,056 people received Covid-19 vaccine jabs on the first day on Friday, March 5, as the vaccination exercise kicked off country-wide. They included people at high risk – priority groups including health workers, the elderly, and those with underlying health conditions. As one of the first people to be vaccinated against Covid-19, Christine expresses her gratitude to the Government of Rwanda for having offered to her a free vaccine to protect her life. ‘I feel so privileged. I hadn’t imagined being vaccinated so soon. It’s gratifying that the government considered community health workers among the first to receive the vaccine.’ she said, going on to explain that having the vaccine will allow her to continue her vital work with the knowledge that she is protected. 

Through its Community Health and Social Medicine Department, UGHE has trained 72 CHWs including Christine on teaching methodologies that help them to conduct effective community outreach, education, and mobilisation campaigns – such as the current vaccine roll-out. Seeing CHWs and their unique community expertise and insight as integral to student learning, the Department also includes CHWs as educators for medical students at UGHE. They teach  innovative healthcare practices and share their experiences in the areas of behavioural change education, disease screenings, child and maternal healthcare, family planning, and nutrition programs.

Going forward, UGHE plans to strengthen the partnership with CHWs through diverse educational programs and increased opportunities to share their expertise with students from across the globe.