abstract: 'Background Community health workers (CHWs) in Afghanistan are a critical

  care extender for primary health services, including reproductive,

  maternal, neonatal, and child health (RMNCH) care. However, volunteer

  CHWs face challenges including an ever-expanding number of tasks and

  insufficient time to conduct them. We piloted a health video library

  (HVL) intervention, a tablet-based tool to improve health promotion and

  counseling by CHWs. We qualitatively assessed provider-level

  acceptability and operational feasibility. Methods CHWs implemented the

  HVL pilot in three rural districts of Balkh, Herat, and Kandahar

  provinces. We employed qualitative methods, conducting 47 in-depth

  interviews (IDIs) with male and female CHWs and six IDIs with community

  health supervisors. We used semi-structured interview guides to explore

  provider perceptions of program implementation processes and solicit

  feedback on how to improve the HVL intervention to inform scale-up. We

  conducted a thematic analysis. Results CHWs reported that the HVL

  increased time efficiencies, reduced work burden, and enhanced

  professional credibility within their communities. CHWs felt video

  content and format were accessible for low literacy clients, but also

  identified challenges to operational feasibility. Although tablets were

  considered easy-to-use, certain technical issues required continued

  support from supervisors and family. Charging tablets was difficult due

  to inconsistent electricity access. Although some CHWs reported reaching

  most households in their catchment area for visits with the HVL, others

  were unable to visit all households due to sizeable populations and

  gender-related barriers, including women''s limited mobility. Conclusions

  The HVL was acceptable and feasible for integration into existing CHW

  duties, indicating it may improve RMNCH counseling, contributing to

  increased care-seeking behaviors in Afghanistan. Short-term challenges

  with technology and hardware can be addressed through continued training

  and provision of solar chargers. Longer-term challenges, including

  tablet costs, community coverage, and gender issues, require further

  consideration with an emphasis on equitable distribution.'
affiliation: 'Lorenzetti, L (Corresponding Author), FHI 360, Global Hlth Populat \&
  Nutr, Durham, NC 27701 USA.

  Lorenzetti, Lara; Tharaldson, Jenae; Pradhan, Subarna; Dulli, Lisa S.; Todd, Catherine
  S., FHI 360, Global Hlth Populat \& Nutr, Durham, NC 27701 USA.

  Rastagar, Sayed Haroon; Ahmadzai, Sharif A. H., FHI 360, HEMAYAT Project, Kabul,
  Afghanistan.

  Hemat, Shafiqullah, Minist Publ Hlth, Hlth Promot Dept, Kabul, Afghanistan.

  Weissman, Amy, FHI 360, Asia Pacific Reg Off, Bangkok, Thailand.'
article-number: '35'
author: Lorenzetti, Lara and Tharaldson, Jenae and Pradhan, Subarna and Rastagar,
  Sayed Haroon and Hemat, Shafiqullah and Ahmadzai, Sharif A. H. and Dulli, Lisa S.
  and Weissman, Amy and Todd, Catherine S.
author-email: llorenzetti@fhi360.org
author_list:
- family: Lorenzetti
  given: Lara
- family: Tharaldson
  given: Jenae
- family: Pradhan
  given: Subarna
- family: Rastagar
  given: Sayed Haroon
- family: Hemat
  given: Shafiqullah
- family: Ahmadzai
  given: Sharif A. H.
- family: Dulli
  given: Lisa S.
- family: Weissman
  given: Amy
- family: Todd
  given: Catherine S.
da: '2023-09-28'
doi: 10.1186/s12960-020-00477-9
eissn: 1478-4491
files: []
journal: HUMAN RESOURCES FOR HEALTH
keywords: 'Afghanistan; Community health workers; Maternal health; Demand

  generation; Social and behavior change; Counseling'
keywords-plus: MIDDLE-INCOME COUNTRIES; CHILD HEALTH; CARE
language: English
month: MAY 19
number: '1'
number-of-cited-references: '27'
orcid-numbers: 'Dulli, Lisa/0000-0002-3987-8932

  Lorenzetti, Lara/0000-0003-4758-7390

  Hemat, Shafiqullah/0000-0003-4447-6935'
papis_id: 6ef6747bc534d122e249f221e57c04e5
ref: Lorenzetti2020adaptinghealth
researcherid-numbers: 'Dulli, Lisa/IAP-5119-2023

  '
times-cited: '2'
title: 'Adapting a health video library for use in Afghanistan: provider-level acceptability
  and lessons for strengthening operational feasibility'
type: Article
unique-id: WOS:000537100500001
usage-count-last-180-days: '0'
usage-count-since-2013: '2'
volume: '18'
web-of-science-categories: Health Policy \& Services; Industrial Relations \& Labor
year: '2020'