Exploring Local Health Knowledge and Access: Focus Group Findings from Community Health Workers in Pader District, Uganda

In Northern Uganda, communities continue to face significant health challenges driven by a legacy of conflict, poverty, and structural health system challenges. Community health workers (CHW) play a critical role in rural districts like Pader, where access to formal care remains limited. This study explores CHWs perspectives on community health needs, barriers to care, and priorities for strengthening CHW-led service delivery. Six focus group discussions (7-9 participants each) were conducted with 46 CHWs from across Pader District using a semi-structured topic guide. The guide explored eight key domains: general health, health maintenance, modern versus traditional medicine, nutrition, maternal and infant health, environmental factors, malaria practices, and feedback for the CHW program. CHWs identified malaria, maternal and child health complications, and a rising burden of non-communicable diseases as key community concerns. Major barriers to care included long distances to health facilities, drug stockouts, and inadequate transportation. Although communities had strong awareness of disease symptoms and prevention strategies, financial hardship and service limitations undermined preventive practices and timely care-seeking behavior. CHWs emphasized their growing role as trusted frontline providers but highlighted the need for tools, transportation, ongoing training, supportive supervision, and formal recognition to fulfill their responsibilities effectively. CHWs in Pader District navigate complex structural and resource constraints while serving as trusted liaisons between communities and the formal health system. Their insights point to actionable strategies, such as improved supply chains, transportation, training, and inclusion in program planning, that are vital for building equitable and effective community health systems in post-conflict settings.