Community Health Workers: Key Drivers in Malaria Community Case Management in Zambia

For over a decade, the Zambia Ministry of Health has been implementing programs aimed at reducing malaria prevalence in the Nchelenge district of Luapula Province.High-impact malaria control interventions implemented include indoor residual spraying, long-lasting insecticide net distribution and community case management.Despite this, malaria prevalence remains high.Community health workers (CHWs) are the drivers of community case management (CCM), a strategy promoting early recognition, prompt diagnosis, and treatment of preventable illnesses such as malaria.This systematic desk review aimed to assess the impact of community health workers on Malaria CCM and prevention in the Nchelenge district.Thirty-four (34) studies were reviewed which reported indicators of CHW performance and their roles in community health.The study concluded that CHWs had important preventive, case management and promotive roles in malaria interventions.The review revealed that CHWs can provide good quality malaria care, including performing procedures such as rapid diagnostic tests.The factors perceived to influence CHWs' performance were community support, training, availability of drugs and supplies, incentives, and recognition from formal health workers.Though CHWs are recognized, they are not fully integrated into the health system.To enable their effective integration, the following should be considered: introduce sustainable financing of CCM programs; tailor CHW training to address gaps; and improve sustainable supply chain management of malaria drugs and diagnostics.By expanding CHWs, the number of malaria diagnosis and treatment service points per population is expected to decrease treatment-seeking delays and the percentage of people who progress from mild to severe malaria.