Community health workers integration model in the National Health System (Benin, Togo)

Introduction: At the international level, further reflection on the role of community health workers is in progress. The objective of this work is to develop a model of the integration of community health workers in the National Health System. Method: The study was conducted in Benin and Togo. It was a cluster survey that involved 385 Community Health Workers (CHW), 238 village heads, 92 health care managers selected responsibly, and 6150 households selected in a probabilistic manner. The analysis of the strengths, weaknesses, opportunities and threats of interventions under Community directives has contributed to the development of the model. Results : In both countries, community health reference materials existed, and 98.4% community health workers were trained before the beginning of the activities, and all have an intrinsic motivation for the work they do. Only 31.3% of households participated in the selection of community health workers in their locality. The absence of laws recognizing the work of the CHW is a threat to their integration into the healthcare system. The main elements proposed in the model are, the development of the status of community health workers, their remuneration on a budget managed by the health district and fed by several sources. Conclusion: Community Health Workers should not be a health care alternative, but an integral part of the national health system.