Challenges in non-communicable disease mitigation among community health workers: A scoping review

Abstract

Background: There is an increase in non-communicable diseases (NCDs) in Africa, amid a high health worker shortage, necessitating task-sharing with community health workers (CHWs). However, task sharing with CHWs may not have positive patient outcomes, as they face several challenges.
Aim: To describe the task-sharing challenges faced by CHWs in NCDs mitigation.
Setting: Studies conducted in Africa were selected.
Method: The Arksey and O’ Marley Framework was used. Included articles were published in English from 2015 to 2025. PubMed, ScienceDirect, and Google Scholar were searched from 26 March 2025. Two reviewers used Covidence to select studies, and conflicts were resolved through discussions. The researchers developed the data extraction tool and used content analysis to analyse data.
Results: Articles screened by title were 189, with a final selection of 14 articles. The review found that an individual-level challenge was a lack of skills and inadequate knowledge. Organization-level challenges included a lack of supervision, a lack of equipment and infrastructure, and a poor referral system. Community-level challenges included safety concerns, poverty among community members, lack of transport, and mistrust of community health workers.
Conclusion: It is essential to capacitate CHWs through continued supervision and training, and with policies that address broader socio-economic challenges like poverty and crime in Africa.
Contribution: The study contributes to increasing the efficiency of the African CHWs by providing insights into the challenges they experience so that these challenges may be addressed.