“I am the bridge”: Examining intersectoral collaboration among community health workers to address maternal and child health in the Philippines

Abstract

Introduction

Community health workers (CHWs) are uniquely positioned to act as a bridge between local maternal and child health needs and the broader health system. However, there is a need to examine the specific strategies CHWs use to facilitate intersectoral collaboration and support community-level maternal and child health service delivery.

Methods

This study was conducted in partnership with a Philippines-based NGO and their CHW program. In total, 64 semi-structured interviews were conducted with CHWs from six locations in Negros Oriental, Philippines. Data collection focused on CHWs’ efforts to address maternal and child health and collaborate across sectors to support health service delivery. Qualitative data were analyzed with a hybrid inductive-deductive approach.

Results

CHWs (all females; ages 21–60) leveraged the multiple roles and social networks they held, including with local health system and government actors, to address maternal and child health. CHWs viewed their role as addressing service gaps and providing continuity of care with the public health system (service extenders); liaising between communities and both the NGO and public sector to support service navigation (cultural brokers); and working to address complex social and ecological determinants of health within their communities (social change agents).

Conclusion

This study provides insights into how NGO-public sector collaboration is facilitated by CHWs to support maternal and child health in communities. In addition, this study demonstrates how broader health system governance arrangements and decentralization may impact the experiences and roles of CHWs affiliated with NGO-led programs.