Rwanda: Study Highlights Need to Train Community Health Workers in Post-Surgery Care

Community health workers in Rwanda could play a crucial role in post-surgical care and surgical research, according to a new study.

The study, whose findings were presented at the Pan-African Surgical Conference on February 27, was conducted between 2022 and 2023 at Kibagabaga and Kibogora Level Two teaching hospitals. Its findings highlight the potential of community health workers in bridging gaps in surgical care and improving patient outcomes.

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Alphonsine Imanishimwe, a researcher at the Global Surgery Research Hub, explained that the first phase of the study focused on understanding the perceptions of community health workers (CHW) regarding their role in surgical care.

“Ninety-eight per cent of CHWs surveyed agreed that they could play a role in following up with patients after surgery within the community to prevent infections and other post-surgical complications,” Imanishimwe said.

“After surgery, patients typically return for follow-up appointments with the surgeons who operated on them. However, complications could sometimes arise before these scheduled visits, and patients may overlook symptoms that could lead to serious health issues. Factors such as long travel distances and waiting time for surgeons, who also have a big number of patients to deal with, often contribute to these delays in seeking care.”

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Imanishimwe also said that despite community health workers being an integral part of Rwanda’s healthcare system since 1995, their involvement in surgical care has been minimal.

“With the right training and clear guidelines, CHWs can bridge the gap between hospitals and communities, improving patient recovery while also shifting negative perceptions about surgery,” she said.

Moreover, she noted that those who were asked during the study highlighted systemic challenges, including inadequate resources, unclear roles, and limited collaboration with healthcare professionals, which hindered their full participation in surgical care. If all this was taken care of, it would really play a huge role post-surgery care.

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There are more than 58,000 community health workers in Rwanda.

Mathias Nkiranya, a community health worker from Musanze District, said if they were given proper training, they would support post-surgical care as effectively as they do in other healthcare services, such as maternal and child health, as well as malaria prevention.

“If we were trained to care for malaria patients and are now doing it successfully, why not expand our skills to surgical care? Community health workers could play a vital role in patient follow-ups, ensuring they take medication as prescribed, preventing infections, and providing crucial recovery support,” he said.

“Given the fact that they are close to patients allows, they would be able to identify complications early, potentially reducing hospital readmissions and improving surgical outcomes.”

“With the right training, we can ensure that post-surgical patients recover safely, prevent complications, and bring quality healthcare closer to those who need it most,” said Jacqueline Mukamunana, a community health worker from Nyagatare District.

The study suggests enhancing training for community health workers to support in post-surgery care.

“There is a need to develop structured guidelines to formally involve CHWs in surgical care, a stronger collaboration between CHWs, healthcare professionals, and researchers is essential to improving surgical care integration,” said Imanishimwe.

“The need for community awareness campaigns to dispel misconceptions surrounding surgery and foster public confidence in surgical care is also essential. By educating communities about the benefits of after-surgery care and the roles of CHWs can also help a lot.”

These initiatives can help reduce stigma, encourage timely medical interventions, and empower CHWs to play a more active role in post-surgical support, Imanishimwe said.

By equipping CHWs with the necessary training and resources, Rwanda has an opportunity to enhance post-surgical care and improve overall healthcare outcomes, especially in rural and underserved communities, she said.