| Barriers identified | Effect on CHVs performance | Acton taken by research team |
| Low literacy level of CHVs | - Incomplete forms - inability to comprehend the questions in the data collection tools - rephrasing the questions and misinterpretations of terms - Inability to read the questions and inability to write responses correctly on the forms | - Introduced the peer to peer strategy - Capacity building bridging workshop to reflect and revisit terms that were identified from the monthly data collection forms as not having been well understood misconceived, or misinterpreted by the CHVs - Conducted discussions with the facility staffs and discussed the results of the study especially highlighting the challenges that CHVs were experiencing and importance of the referral system |
| Weak referral system | - Health facility staffs’ refusal to accept complete the referral forms - weak community health structures - insufficient supervision of CHVs - CHVs felt demotivated and demoralized - Low morale of CHVs | |
| Weak community structures | - low morale of CHVs - insufficient supervision - poor implementation of CHVs activities in their respective villages - negative attitude by the facility staffs | |
| Insufficient supervision | - Low morale - High CHVs turnover - Demotivated CHVs | |
| Multiplicity of roles | - Work overload - Delayed reports - Absenteeism during monthly meeting - Credibility of reports |