A Comprehensive Assessment of Community Health Workers Cooperatives

Community health workers are on the first line of health delivery in Rwanda since 1995. We conducted a cross-sectional mixed method study to the Southern Kayonza district CHWs’ cooperatives. Findings show that among cooperative members with no other formal role, most of them are not informed about what is happening in the cooperatives. On the side of the perception of leaders, members expect leaders to be more innovative in what activities will lead to the cooperatives’ profitability. The use of accounting and finance tools is still low as well the awareness of taxes compliance. Additionally, cooperatives do not carry out business planning before investing. The highest return on investment recorded was 20 % and 75 % of the cooperatives have had a positive return on investment over the past four years. Significant associations were found between cooperative activities, being registered in the national gazette, having at least one full-time employee, tax payment and the outcome variable of having a positive return on investment at pless than0.2. This study recommends to the cooperatives a proper market and business analysis, proper use of accounting and finance tools and involvement of members in knowing the financial status of the cooperative through frequent meetings.