Co-designing the 'Empower Community Health' programme: A capacity-building initiative to support community health workers' non-communicable disease health promotion in Ethiopia.

BACKGROUND

Non-communicable diseases (NCDs) disproportionately affect low- and middle-income countries, including Ethiopia. However, community health workers' (CHWs') capacity in NCD health promotion is sometimes limited.

AIM: This study aimed to co-design a contextually appropriate intervention with and for CHWs to support their NCD health promotion services.

SETTING

This co-design study was conducted in Gondar City, northwest Ethiopia. The workshops were held in the meeting hall at the University of Gondar.

METHODS

A qualitative participatory action research design, guided by the PRODUCES (Problem, Objective, Design, User, Co-creators, Evaluation, and Scalability) framework, was employed. Sixteen participants, including CHWs (n = 6), community-dwelling adults with (n = 3) and without NCD diagnoses (n = 3), and health system managers (n = 4) were recruited using convenience and purposive sampling. Participants attended three workshops. In workshop 1, participants discussed the roles of CHWs in health promotion and areas for improvement. Workshop 2 focused on intervention components and delivery approaches. A draft of the intervention was reviewed during workshop 3. Discussion notes and artefacts were thematically analysed in NVivo.

RESULTS

A 6-week, multicomponent intervention, 'Empower Community Health', was co-designed. Key themes included: (1) knowledge capacity building, (2) personal behaviour change, and (3) community-outreach initiatives. Proposed intervention topics included: (1) learning about NCDs; (2) skill motivational interviewing; and (3) behaviour change for diet and physical activity.

CONCLUSION

The involvement of intervention users and stakeholders allowed for the sharing of experiences and fostered ownership in the 'Empower Community Health' programme.Contribution: The meaningful engagement of stakeholders ensures that the intervention is tailored to their needs, fosters ownership and enhances intervention buy-in. This study provides practical guidance for future co-designed health promotion programmes.