I have learned to stand up for myself and demand my rights: Community Health Volunteers are changing social norms

Background:The community health volunteers (CHV) model is a practical response to the challenging conditions of health provision in low-income settings. Though there is substantial evidence about the effectiveness of the CHV model, there is less focus on the CHVs themselves. This project explores the personal transformations that can happen as well as perceptions of women in a qualitative study of CHVs working with the Peru Catholic Medical Mission Board (CMMB), an NGO that utilizes a robust CHV model of healthcare.Methods:In March 2020, investigators conducted six 90-minute focus group discussions in Huancayo and Trujillo, Peru with current and former CHVs. The focus group discussion guides were designed to explore how becoming a CHV has impacted their lives. Investigators performed a systematic, comparative, and thematic data analysis.Results:The 53 Peruvian participants had worked with CMMB as a CHV for an average of 5 years. Major themes that emerged from the discussions fell into two main categories: 1) personal empowerment and 2) societal norms. Increase in agency (voice, confidence, participation) was the most common personal empowerment theme followed by achievements (education, health, nutrition). There was a major increase in family support including a shift in household gender roles as a result of working as a CHV.Conclusions:To effect positive change in global communities, it is crucial to understand how working as a CHV can empower women to influence social structures barring their advancement in society. The results of this analysis demonstrates that working as a CHV can empower women and help create social change, with ultimate benefits to the lives of community women in low resource settings