A qualitative exploration of community health workers' roles and motivations in delivering care during and after the COVID-19 pandemic: experiences and community perceptions in rural and urban Delhi, India.

BACKGROUND

This study examines the experiences of community health workers (CHWs) providing care in Delhi India during and after the COVID-19 pandemic, and how their roles were perceived and accepted by beneficiaries and community leaders. Although CHWs are critical to healthcare delivery, limited evidence describes how they navigate role expectations, community dynamics, and system complexities to better improve health outcomes.

METHODS

A qualitative descriptive study using semi-structured interviews and field observations with 12 CHWs, five community members, and four community leaders (March-May 2025). The Lévesque conceptual framework guided data collection and analysis. Data were analyzed using content analysis.

RESULTS

Across the supply-side domains (approachability, acceptability, availability/accommodation, affordability, and appropriateness), three key categories emerged: (1) trust and respect, (2) professional values, and (3) norms, culture, and family. For the demand-side domains (ability to perceive, seek, reach, pay, and engage), one key category, community needs was identified. COVID-19 impacts and quality-of-care concerns were evident across all domains.

CONCLUSIONS

Findings highlight the need for future research on sociocultural influences shaping CHWs' professional roles, the sustainability of incentive-based remuneration, and the long-term implications of digital technologies adopted during a crises such as COVID-19.