Examining the role of community health workers amid extreme weather events in low- and middle-income countries: a scoping review

Objectives: The increased frequency and severity of extreme weather events (EWEs) have underscored the need to strengthen climate-resilient health systems and capacity. Community health workers (CHWs) are integral health systems actors with the potential to protect and improve population health in a changing climate. The aim of this review was to synthesize the literature on the roles of CHWs amid EWEs in low- and middle-income countries, the barriers and facilitators to implement these roles, and program supports to strengthen CHW capacity and health system functions. Study design: Scoping review. Methods: Four academic databases and gray literature published between January 2000 and June 2023 were searched. Data were thematically analyzed using a deductive-inductive approach guided by the World Health Organization's (WHO's) Operational framework for building climate-resilient health systems. Results: Thirty sources were included. Amid EWEs, CHW roles included: 1) delivery of diagnostic, treatment, and other clinical services; 2) support with access, utilization, or navigation of health services and/or referrals; 3) community education and health promotion; 4) data collection and health surveillance; 5) psychosocial supports; and 6) weather-related health emergency response. Facilitators and barriers to the provision of CHW supports amid EWEs were categorized within WHO's building blocks of health systems. Considerations for strengthening CHW programs to enhance climate-resilient health systems are also discussed. Conclusions: CHWs are uniquely positioned to provide health-related supports amid EWEs that extend to emergency preparedness and response to climate-health challenges. These efforts can contribute to the community and health systems resilience to climate change. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4. 0/).