INTRODUCTION: Community Health Workers (CHWs) play an increasingly vital role in primary healthcare across low- and middle-income countries (LMICs), yet their involvement in surgical care remains underexplored. In Rwanda, CHWs are well-integrated into the health system, but their potential to support surgical outcomes, particularly in post-operative care and research, has not been systematically examined.
METHODS: This mixed-methods study investigated CHWs’ perceptions and roles in surgical care in Rwanda. Data were collected through four focus group discussions (FGDs) with 42 CHWs and a cross-sectional survey administered to 185 CHWs across rural and urban settings. Qualitative data were thematically analysed, while quantitative data were analysed using descriptive statistics.
RESULTS: CHWs demonstrated a comprehensive understanding of the surgical care continuum, including pre-operative education, post-operative follow-up, and complication recognition. Notably, 72.43% of surveyed CHWs reported encountering post-operative patients needing follow-up care, and 64.13% had identified complications such as wound infections or hospital readmissions. Nearly all participants (98.91%) expressed confidence in promoting community engagement and post-operative support. However, gaps in formal training, limited access to surgical knowledge, and barriers to participation in research were frequently cited. Despite this, 98.91% of CHWs expressed interest in contributing to surgical research, underscoring their untapped potential in data collection and health system strengthening.
CONCLUSION: CHWs in Rwanda are well-positioned to support surgical care, particularly through post-operative follow-up, patient education, and early identification of complications. Their trusted role in communities makes them ideal partners for expanding surgical outreach and research. Investing in targeted training and integration strategies could enhance surgical outcomes and reduce complications in low-resource settings.
