Potential impacts on CHEWs | Potential impacts on existing lay counsellors | Potential impacts on CHVs | Potential impacts at the community level | |
---|---|---|---|---|
Perceptions at macro level national and county policymakers | CHEWs trained and competent in HTC Too many tasks could dilute quality and accountability | Skilled group taken up as part of Community Health Services and ‘home testing’ within health system | Increased clarity on HBTC support functions of CHVs Concerns about workload | Normalises HIV testing Enables holistic services to be delivered at home |
Perceptions at meso-level and county-level implementers | Improved county coordination of vertical programmes and of interorganisational relationships | Integrated approach to training, supervision, data management, commodities and supplies. Potential for stock outs | Improved supervision and support for HIV services offered, able to conduct current HIV tasks within an official framework | Opportunity to extend HIV services within the community |
Perceptions at micro level—community level actors | CHEWs able to offer HBTC at home for pregnant women, TB patient contacts, families of HIV-positive individuals | Offer services additional to current HBTC roles | Holistic picture of the household; able to mobilise for HIV testing, support linkage from community to health facility; able to respond to community demand for HTC or to provide condoms | Availability of condoms at the community level Easier access to HTC, increased uptake especially among men Holistic care available at the community level Concerns about confidentiality and stigma |
CHEWs, community health extension workers; CHVs, community health volunteers; HBTC, home-based testing and counselling; HTC, HIV testing and counselling; TB, tuberculosis.