Community perceptions of the health care worker-based wound management model “Identify and treat wounds early” including skin NTDs in rural Côte d’ Ivoire

Background: Skin wounds affect millions of people in Africa. In rural communities’ wounds are highly prevalent due to trauma including snakebites and a wide range of infections including skin NTDs. Wound prevention and access to health services is limited due to health system related (infrastructures, materials, human resources), environmental, sociocultural and economics factors. The burden of chronic and complicated wounds is correspondingly high. The aim of this study is to investigate the community perceptions, perceived benefits and challenges of the community health worker-based wound management. Methods: We conducted mixed cross-sectional research in the rural Taabo Health demographic Surveillance System (HDSS) where the wound management project “Identify & treat wounds early” is implemented since 2019. Quantitative data was collected in 191 households randomly selected. Qualitative data was gathered from 16 in-depth interviews, 10 Focus Group Discussions involving former patients, health care personnel, traditional practitioners, and village authorities. Results: 96.9% of households were satisfied with the CHW-based service, particularly with fast healing of wounds (40.3 %), availability of the CHWs (31.9 %), sensitiveness and sociability of the CHWs (13.1%). The perceived benefits were reduction of severe wounds (33%), early recourse to care (32%), trust in CHWs care (20%) and physical well-being and wound hygiene improvement in children’s (15%). Recourse to traditional healers and self-medication diminished. Challenges are incomplete CHW coverage of households due to poor or slow integration of CHWs into the healthcare system of Côte d'Ivoire, including security of income, provision of wound dressing materials and equipment. Conclusion: Community-based CHWs are highly appreciated by the community for accessible, effective, sensitive and socially acceptable wound management. CHWs could play an important role in the prevention, early identification and treatment of wounds.