Challenges and Experiences of Community Health Workers in Delivering Maternal and Child Health Services: A Review

Abstract

Community Health Workers (CHWs) play a pivotal role in delivering maternal and child health (MCH) services, particularly in low- and middle-income settings where access to healthcare remains limited. This review explores the experiences and challenges of CHWs and examines their impact on the delivery of maternal and child health services. Evidence indicates that CHWs improve healthcare access, promote preventive health practices, and strengthen community engagement through culturally appropriate, community-based interventions. However, they face numerous challenges, including heavy workloads, inadequate training, financial insecurity, insufficient supportive supervision, and sociocultural barriers, all of which adversely affect their motivation, performance, and quality of service delivery. These constraints contribute to reduced service coverage, inconsistent quality of care, and increased workforce attrition, ultimately weakening primary healthcare systems. Despite these challenges, CHWs continue to demonstrate remarkable commitment and resilience in serving their communities. Strengthening CHW programmes through continuous capacity building, fair remuneration, supportive supervision, and effective integration into formal healthcare systems is essential for enhancing their effectiveness and long-term sustainability. Investing in CHWs is critical to advancing universal health coverage and improving maternal and child health outcomes in underserved populations.