Our research is focused on urban slums and remote rural areas in Bangladesh and Kenya. Community Health Workers (CHWs) are globally acknowledged as a vital health workforce and a bridge between informal community health systems, and formal healthcare facilities. In resource-constrained settings like Kenya and Bangladesh, CHWs are often the only point of contact with formal health services particularly for poor people in urban informal settlements and rural contexts. CHWs bear heavy workloads, are under-prioritised, have minimal supervisory support, and the majority are not fairly compensated for their work.

In Kenya, a CHW supports 100 households, largely in a voluntary capacity. Recent reforms by the Kenyan government seek to enhance working conditions for community health workers- the government has provided each community health worker with mobile phones to ease data collection and management. Additionally, the community health promoters have been provided kits containing equipment for supporting healthcare interventions at the household level- these include blood pressure, first aid, blood glucose, anthropometric measures among other tools. Additionally, the Kenyan government provides a monthly stipend of 5000 shillings to the community health workers.

There is scarce published evidence on CHWs’ mental well-being and available support within the community health systems. Research evidence has largely focused on CHWs’ roles and experiences, but very little on work-related stressors and CHWs’ mental well-being. This study explored community health workers’ stressors, their coping mechanisms, and the perspectives and experiences of policymakers in Kenya about policies and plans for enhancing the mental well-being of CHWs in Kenya. Based on the study evidence CHWs and health care stakeholders are engaged in identifying and co-designing sustainable mental wellbeing interventions.

In Kenya,our urban study sites are in informal settlements in Viwandani and Korogocho, both located in Nairobi City County. The rural study sites, are Lari and Gatundu North, which are situated in Kiambu County.

Bangladesh has a well-established and successful history of CHW programs. These programs have been instrumental in improving health outcomes, particularly in rural areas, by delivering essential primary healthcare services. For more than 40 years, both the government and NGOs have worked, sometimes in collaboration, sometimes in parallel, to establish robust CHWs programmes in Bangladesh. The country has over 185,000 CHWs, around 70,000 are employed by the government and the rest by NGOs. SHINE has explored four prime cadres from Bangladesh, Health Assistants (HAs) and Community Health Care Providers (CHCPs) under the Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MOHFW) and paid full-time workers Shasthya Kormi (SKs) and volunteers Shasthya Shebika (SSs) employed by BRAC Health Programme (BHP). CHWs in Bangladesh are providing primary healthcare services and serve as ‘change agent’, empowering communities by enhancing their awareness of health issues, generating demand for high-quality healthcare services and bridging the gap between the community and healthcare facilities. Given their role and contribution, they are not adequately recognised, supported. There is limited evidence on CHWs work-related, social, and personal stressors affecting their mental well-being.

In Bangladesh, research focuses on peri-urban and rural settings. The study sites in Bangladesh include five upazilas selected from Mymensingh (Muktagacha, Trishal, Bhaluka, Nandail and Dhobaura) and Barisal (Agailjhara, Babuganj, Gournadi, Muladi and Hizla) districts.