Community health workers’ non-technical skills for delivering primary healthcare in low-income areas

To overcome the poor conditions of low-income areas in developing countries like Brazil, Community Health Workers (CHWs) are required to exceed the regular set of formal skills they are used to employ. In this study, we aim at identifying the non-technical skills CHWs must develop to cope with the extraordinary situations that occur in vulnerable communities. 41 CHWs based in two primary healthcare clinics in Brazil underwent two rounds of in-depth interviews. The analysis was carried out using the Analytical Hierarchy Process, resulting in the prioritization of social skills according to their calculated importance to house calls. Among the ten higher-scored skills, we find communication and advocacy skills being of high importance. Civility was found to be the most important attribute, confirming that community action relies strongly on the relationship between health professionals and the community. The results of our study contribute primarily to the improvement of community-based primary care programs as it helps to identify major skills required for community action.