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Background <p>The impact of COVID-19 across different territories in Brazil was shaped by social determinants, affecting vulnerable populations, including those experiencing violence. Understanding how COVID-19 pandemic affected and was managed at the primary health care (PHC) sheds light on how to prepare for, prevent, manage, and mitigate the impact of future pandemics. The aim of this study was to evaluate the perceived violence, work process, mental health, quality of life, self-efficacy, and social support of community health workers (CHW) in the trans- and post-COVID-19 pandemic period.</p> Methods <p>A multi-site, quantitative study was conducted in eight different municipalities in the Northeast Region of Brazil in 2021 (<i>n</i> = 1944 CHWs) and in 2023 (<i>n</i> = 1915 CHWs) employing a self-administered questionnaire. Statistical analysis included chi-square, <i>t</i>-test, multivariate analysis of variance (MANOVA), and Cochran’s Q tests.</p> Results <p>At the end of COVID-19 (2023), improvement was observed in CHWs’ quality of life, self-efficacy, and a decrease seen in the percentage of CHWs at risk of common mental disorders. There was also an increase in the diversity of work activities conducted by the CHWs and in the types of home visits they conducted. Although, the quantity of those activities remains lower when compared to pre COVID-19 era. A decrease in anxiety related to coronavirus, social support and in the psychological domain of quality of life was observed. Violence was observed in more than three quarters of the communities, influencing CHWs’ health and ability to work, with about 30% of CHWs reporting they stopped caring for families due to violence.</p> Conclusions <p>Perceived violence by CHWs (i.e., ever saw/heard of violence in the community) increased in capital cities with time while diminishing in the inner cities. A larger increase in the types of work activities, including home visits performed by CHWs, in capital cities was noted over time. These changes are likely affecting PHC functioning and the care offered.</p>

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Psychosocial, organizational, and health aspects related to the labor of community health workers in the trans- and post-COVID-19 pandemic period in Brazil’s Northeast Region

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Anya P. G. F. Vieira-Meyer,
  • Roger Silva Sousa,
  • Neiva Francenely C. Vieira,
  • Franklin Delano Forte,
  • Ardigleusa Alves Coelho,
  • Maria de Fatima Antero Sousa Machado,
  • Maria Socorro de Araújo Dias,
  • Maristela Inês Osawa Vasconcelos,
  • Marcia C. Castro,
  • Aisha K. Yousafzai

摘要

Background

The impact of COVID-19 across different territories in Brazil was shaped by social determinants, affecting vulnerable populations, including those experiencing violence. Understanding how COVID-19 pandemic affected and was managed at the primary health care (PHC) sheds light on how to prepare for, prevent, manage, and mitigate the impact of future pandemics. The aim of this study was to evaluate the perceived violence, work process, mental health, quality of life, self-efficacy, and social support of community health workers (CHW) in the trans- and post-COVID-19 pandemic period.

Methods

A multi-site, quantitative study was conducted in eight different municipalities in the Northeast Region of Brazil in 2021 (n = 1944 CHWs) and in 2023 (n = 1915 CHWs) employing a self-administered questionnaire. Statistical analysis included chi-square, t-test, multivariate analysis of variance (MANOVA), and Cochran’s Q tests.

Results

At the end of COVID-19 (2023), improvement was observed in CHWs’ quality of life, self-efficacy, and a decrease seen in the percentage of CHWs at risk of common mental disorders. There was also an increase in the diversity of work activities conducted by the CHWs and in the types of home visits they conducted. Although, the quantity of those activities remains lower when compared to pre COVID-19 era. A decrease in anxiety related to coronavirus, social support and in the psychological domain of quality of life was observed. Violence was observed in more than three quarters of the communities, influencing CHWs’ health and ability to work, with about 30% of CHWs reporting they stopped caring for families due to violence.

Conclusions

Perceived violence by CHWs (i.e., ever saw/heard of violence in the community) increased in capital cities with time while diminishing in the inner cities. A larger increase in the types of work activities, including home visits performed by CHWs, in capital cities was noted over time. These changes are likely affecting PHC functioning and the care offered.