The Gendered Experience of Close to Community Providers during COVID-19 Response in Fragile Settings: A Multi-Country Analysis

Joanna Raven (), Abriti Arjyal, Sushil Baral, Obindra Chand, Kate Hawkins, Lansana Kallon, Wesam Mansour, Ayuska Parajuli, Kyu Kyu Than, Haja Wurie, Rouham Yamout and Sally Theobald
Additional contact information
Joanna Raven: Department of Public Health, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
Abriti Arjyal: HERD International, Kathmandu 44600, Nepal
Sushil Baral: HERD International, Kathmandu 44600, Nepal
Obindra Chand: HERD International, Kathmandu 44600, Nepal
Kate Hawkins: Pamoja Communications, Brighton BN2 4AY, UK
Lansana Kallon: College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
Wesam Mansour: Department of Public Health, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
Ayuska Parajuli: HERD International, Kathmandu 44600, Nepal
Kyu Kyu Than: Burnet Institute, Yangon 3004, Myanmar
Haja Wurie: College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone
Rouham Yamout: Faculty of Health Sciences, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon
Sally Theobald: Department of Public Health, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK

Social Sciences, 2022, vol. 11, issue 9, 1-21

Abstract: Many countries, and particularly those including fragile contexts, have a shortage of formal health workers and are increasingly looking to close-to-community (CTC) providers to fill the gap. The experiences of CTC providers are shaped by context-embedded gender roles and relations. This qualitative research study in Lebanon, Nepal, Myanmar and Sierra Leone explored the gendered experiences of CTC providers during the COVID-19 pandemic in fragile settings. We used document review, in-depth interviews or focus group discussions with CTC providers, and key informant interviews with local stakeholders to generate in-depth and contextual information. The COVID-19-associated lockdowns and school closures brought additional stresses, with a gendered division of labour acutely felt by women CTC providers. Their work is poorly or not remunerated and is seen as risky. CTC providers are embedded within their communities with a strong willingness to serve. However, they experienced fractures in community trust and were sometimes viewed as a COVID-19 risk. During COVID-19, CTC providers experienced additional responsibilities on top of their routine work and family commitments, shaped by gender, and were not always receiving the support required. Understanding their experience through a gender lens is critical to developing equitable and inclusive approaches to support the COVID-19 response and future crises.

Keywords: close-to-community providers; gender; justice; fragile settings; COVID-19; community health workers; health policy (search for similar items in EconPapers)
JEL-codes: A B N P Y80 Z00 (search for similar items in EconPapers)
Date: 2022
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