Work

Exploring mental well-being of community health workers in Bangladesh: Using photovoice to illuminate stressors, coping strategies, and sources of motivation

Year: 2026

Type: article

Abstract: Community health workers (CHWs) are on the frontline of primary health care in Bangladesh and vital for maternal and child health, immunisation, and basic health education services in rural and underserved communities. However, their mental well-being remains largely neglected, underscoring the need for evidence to guide supportive strategies. In this multicounty study, we used photovoice, a community-based participatory research method, with 20 government and non-government CHWs from two purposively selected districts. Trained as co-researchers, the CHWs documented their lived experiences through photographs and collaboratively analysed stressors, motivations and desired changes. Using powerful metaphors, government CHWs described an overwhelming workload, poor infrastructure, medicine shortages, irregular training, unsupportive supervision, job insecurity, low and irregular salaries, and limited career progression as their key stressors. NGO sector CHWs reported unrealistic targets, monitoring pressures, and extensive travel while receiving low salaries and meagre incentives; the latter are often supplemented by sideline farming and livestock rearing to sustain livelihoods. Gender related stressors included women struggling to balance workplace and household duties, while men faced pressures as primary earners. Despite these challenges, CHWs demonstrated resilience through savings, side businesses, religion, and family support, while many took pride in their role as trusted health advisors in the community. Findings underscore the need for policies that prioritise CHWs’ mental wellbeing through fair remuneration, psychosocial support, regular refreshers, career advancement, and supportive supervision. Future research should assess how improving CHWs’ wellbeing influences job retention and service-delivery outcomes.

Source: SSM - Health Systems

DOI: 10.1016/j.ssmhs.2026.100258