Table 5.

Change in this study using Lewin’s three-stage model

Stage	Organisational action that occurred	Factors for or against working together
		Facilitators	Barriers
Unfreeze	Policy-makers introduce rPHC and the HP policy and launch the new reform	• Health promoters know communities well	• Limited re-alignment of HPPs for new roles:  ◦ job descriptions  ◦ re-training
Change	HPPs and CHWs/WBOTs experiment on how to work together on the ground	• HPPs as forerunners of the CHW programme	• Role overlap • More attention and resources towards CHWs • Anxiety and trepidation among HPPs
Refreeze	Some HPPs institutionalise new change into their practice culture	• HPPs train CHWs • Working at part of one WBOT	• Two cadres, and their management structures, working in parallel

CHW community health worker, HP health promotion, HPP health promotion practitioner, rPHC re-engineering of primary healthcare, WBOT Ward-Based Outreach Team