Assessing the demand for community health workers’ social support: a qualitative perspective of mothers in rural Rwanda

Introduction: better utilization of community health workers (CHWs) is considered a key strategy that can improve access to health care services in low resource settings. Community acceptance of the supports that CHWs provide is important to enable CHWs deliver their services and for these services to have long-term benefits. The objective of this study was to examine mothers’ perceptions and demand for CHWs services in two rural districts in Rwanda. Methods: this was a qualitative study and data were collected using 6 focus group interviews. The groups comprised a total of 64 mothers aged 19-42 years who had delivered within the last year preceding the study. Thematic analysis of the group interviews resulted in three major themes related to social support a) informational b) emotional and c) tangible support. Results: informational support (advice on nutrition, antenatal care, delivery care) was by far the most valued support by mothers. Mothers expressed a need for more emotional support from CHWs (for example counselling partners about pregnancy and childbirth) and tangible support (helping mothers to solve practical problems). Conclusion: mothers attach great value to CHWs services but gaps in types of services provided were noted. The findings point to the multiple roles that CHWs may have to play to meet the demands of community members. More studies on the interactions of CHWs with mothers, in particular longitudinal studies are needed to improve the understanding and planning of CHWs interventions.