Breaking the silence on gendered harassment and assault of community health workers: An analysis of ethnographic studies

Svea Closser, Marium Sultan, Roosa Tikkanen, Shalini Singh, Arman Majidulla, Kenneth Maes, Sue Gerber, Anat Rosenthal, Daniel Palazuelos, Yihenew Tesfaye, Erin Finley, Roza Abesha, Ann Keeling, Judith Justice

Research output: Contribution to journalArticlepeer-review


Introduction Across a variety of settings, women in tenuous financial circumstances are drawn to community health work as a way to advance themselves in the context of limited employment options. Female Community Health Workers (CHWs) are often preferred because they can more easily access mothers and children; at the same time, gender norms are at the heart of many of the challenges and inequities that these workers encounter. Here, we explore how these gender roles and a lack of formal worker protections leave CHWs vulnerable to violence and sexual harassment, common occurrences that are frequently downplayed or silenced. Methods We are a group of researchers who work on CHW programmes in a variety of contexts globally. The examples here are drawn from our ethnographic research (participant observation and in-depth interviews). Results CHW work creates job opportunities for women in contexts where such opportunities are extremely rare. These jobs can be a lifeline for women with few other options. Yet the threat of violence can be very real: women may face violence from the community, and some experience harassment from supervisors within health programmes. Conclusion Taking gendered harassment and violence seriously in CHW programmes is critical for research and practice. Fulfilling CHWs' vision of health programmes that value them, support them and give them opportunities may be a way for CHW programmes to lead the way in gender-transformative labour practices.

Original languageEnglish (US)
Article numbere011749
JournalBMJ Global Health
Issue number5
StatePublished - May 19 2023


  • Health services research
  • Health systems
  • Public Health
  • Qualitative study

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy


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