Browsing by Author "MBAYA, David Kanyanta"

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An Evaluation of Community Participation in Health Systems Strengthening: A Case of the Community Health Worker (CHW) Programme in Chongwe District
(2026) MBAYA, David Kanyanta
Community participation is widely recognised as a cornerstone of effective primary health care delivery, particularly in low- and middle-income countries where health systems often face resource constraints and limited reach. This study evaluated community participation in the planning, implementation, and governance of the Community Health Worker (CHW) programme in Chongwe District, Zambia, with a specific focus on a health-related software feature introduced to support service delivery. The target population comprised community residents, CHWs, and staff from the Centre for Infectious Disease Research in Zambia (CIRDZ), reflecting a diverse group of stakeholders directly engaged in or affected by the programme. Using a mixed-methods approach, data were collected from 40 respondents out of the current population which sits at above 300,000 people through questionnaires and focus group discussions, enabling both quantitative and qualitative insights into the nature and extent of participation. The findings revealed limited and largely tokenistic community involvement in the planning and prioritisation of the software feature. Specifically, 83% of community residents reported no participation in planning processes, highlighting a disconnect between policy commitments to participatory health governance and actual practice. While participation increased during implementation—73% of residents took part in testing—the quality of engagement was undermined by challenges such as language barriers, inadequate training, and increased workload for CHWs. Feedback and accountability mechanisms were weak, indirect, and non-transparent, contributing to low levels of ownership and trust among community members.