Table 2.
Characteristics, context, aim, study design and quality appraisal of included studies.
| Author and date | Location of the study | Aim/s of the study | Study design | Sample size | Quality appraisal score (%) |
|---|---|---|---|---|---|
| Adam, 2014 | Kenya | To study the effectiveness of a volunteer community health worker project that utilised a health prevention and promotion role for CHWs. | Quasi-experimental design | 83 | 100 |
| Agrawal, 2011 | India | (i) To establish the relationship between the knowledge level of CHWs and auxiliary nurse midwives (ANMs) and antenatal home visits coverage, and (ii) to find out the effect of their knowledge level on essential newborn health care practices at the household level. | Mixed method | 388 | 100 |
| Austin-Evelyn, 2017 | South Africa | To provide a preventive and health-promoting community-based PHC model. | Mixed method | 91 | |
| Brown, 2006 | Peru | To describe the profile of community health workers in rural Quechua communities from Ayacucho, Peru. | Mixed method | 171 | |
| Cordeiro, 2015 | Brazil | To describe and analyse the work of CHWs while focusing on the development of primary health care practices related to harmful drug consumption. | Qualitative | 18 | 100 |
| de Moura Pontes, 2011 | Angola | To know the perceptions and practices of the Angolan community health agents (CHAs) regarding their work and the health of the population. | Mixed method | 640 | |
| Gauteng DoH, 2016 | South Africa | (i) To understand the needs of the community; (ii) To advocate for the people in the community. | Not applicable | Not applicable | |
| Doherty, 2016 | South Africa | To describe the high-impact interventions for pneumonia and diarrhoea which are now leading causes of under-5 mortality. | Quantitative | 126 | 50 |
| Florindo, 2014 | Brazil | To describe the methodology for training to provide counselling on physical activity among CHWs working within primary health care in Brazil. | Quantitative Experimental design | 65 | 100 |
| Javanparast et al, 2011 | Iran | To explore the perceptions of CHWs regarding their contribution to rural health in Iran. | Qualitative | 91 | 100 |
| Koyio et al, 2014 | Kenya | To assess the knowledge and opinions of CHWs regarding HROLs and other oral diseases. | Mixed method | 862 | |
| Le Roux et al, 2015 | Eastern Cape, South Africa | To describe how we have addressed the challenges of Zithulele in the Eastern Cape of South Africa over the last three years. | Quantitative | 50 | 75 |
| Lightspeed, 2015 | South Africa | To determine the issue of proper employment and integration of CHWs in the Free State. | Not applicable | Not applicable | |
| Lindblade et al, 2006 | Kenya | To evaluate the diagnostic accuracy of the WHO Haemoglobin Colour Scale (HCS) for anaemia in three groups of children aged 2 months to 2 years. | Quantitative study | 793 | 100 |
| Mukherjee and Eustache, 2007 | Haiti | To explore the roles of the CHW within the programme of HIV prevention, antiretroviral treatment and the utilisation of AIDS and PHC services. | Mixed method | 163 | 80 |
| Negotiated Service Delivery Agreement, 2012 | South Africa | (i) To strengthen the district health system (DHS) and (ii) to do the basics better. | Not applicable | Not applicable | |
| Nxumalo et al, 2013 | Eastern Cape and Gauteng, South Africa | (i) To focus on the challenges faced by the South African government in addressing increasing health inequities and (ii) to ascertain the current efforts to strengthen primary health care (PHC) through CHWs’ outreach teams. | Qualitative | 15 | 100 |
| Perez et al, 2009 | Mali | To assess the performance of CHWs in the promotion of basic child health services in rural Mali. | Mixed method | 473 | 100 |
| Perry, 2013 | Ethiopia, Malawi, Pakistan and Brazil | To describe the achievements of ‘Health for All’ by the year 2000 through PHC. | Not applicable | Not applicable | |
| Prinja et al, 2014 | India | To bridge the cost of delivery of a platform of health care services delivered through the CHWs at sub-centre (SC) level. | Quantitative | 50 | |
| Rennert and Koop, 2009 | Honduras | To develop a model for the development of sustainable PHC in village communities in Honduras through the training and support of CHWs. | Quantitative | 70 | 75 |
| Roberton et al, 2015 | Tanzania | (i) To explore the experiences of CHWs, supervisors, and village leaders involved in the Integrated MNCH Programme and (ii) to understand the initial strengths and challenges of its CHW supervision model and (iii) to offer further insight into innovations that support CHWs. |
Mixed method | 228 | 100 |
| Signorelli et al, 2018 | Brazil | To describe through ethnographic qualitative research within one specific BHU the intersections between federal policies, the SUS, and professionals who care for women living with domestic violence (DV) in PHC settings. | Qualitative | 15 | 100 |
| Sodo and Bosman, 2017 | Limpopo Province, South Africa | (i) To determine the progress of WBPHCOTs, and (ii) to determine which aspects of the programme need to be improved. | Quantitative methods. | 151 | 75 |
| Sommanustweechai et al, 2016 | Myanmar | To assess the socio-economic profiles’ contributions of CHWs to primary health care services and their need for support to maintain their quality contributions in rural hard-to-reach areas in Myanmar. | Quantitative study | 715 | 100 |
| Suri et al, 2007 | KwaZulu-Natal, South Africa | To identify ways of improving the current CHW programme to more effectively combat the spread of HIV infection and TB. | Quantitative study | 120 | 100 |
| Tilahun et al, 2017 | Ethiopia | To examine training needs and perspectives of community health extension workers (HEWs) in relation to providing child mental health care in rural Ethiopia. | Quantitative study | 104 | 100 |
| Van Ginneken et al, 2010 | South Africa | (i) To explore the factors affecting the late apartheid projects’ evolutions, (ii) to note the extent to which this historical analysis intends to contribute to current debates on the appropriateness, effectiveness and sustainability of CHW initiatives within South Africa and to similar global debates. | Qualitative method | 21 | 100 |
| Whyte, 2015 | Johannesburg, South Africa | To evaluate the implementation of WBOTs against national guidelines and identify (CHWs’ characteristics that influence adherence to guidelines regarding the referral and follow-up of maternal and child health clients. | Quantitative study | 87 | |
| Wilford et al, 2018 | KwaZulu-Natal, South Africa | To explore the quality of CHW household visits to mothers and children using observations and in-depth interviews with mothers and CHWs. (As far as we are aware, this is the first study in South Africa to directly observe and assess care provided by CHWs in households). | A qualitative study design | 45 | 100 |
| Zulu, 2016 | KwaZulu-Natal, South Africa | To evaluate the management and performance systems in order to provide effective and efficient PHC of rural ward-based primary health care in the UThukela District Municipality (UDM). | A mixed methods approach | 385 |