Whose failure counts? A critical reflection on definitions of failure for community health volunteers providing HIV self-testing in a community-based HIV/TB intervention study in urban Malawi
Sambakunsi et al.
Type of approach
Type of assistance
Health-care workers: Community volunteers
Values and preferences
UNAIDS HIV prevalence (2017)
9.1 [8.4 - 9.9]
A performance evaluation was conducted to appraise individual service delivery and to assess achievements in meeting pre-defined targets for uptake of HIVST. This The evaluation included 28 interviews with conusellors in each cluster and a document review that checked all registers and daily work routine documentation outlined in the study protocol.
Summary of findings
In total, 26 of the 28 community counsellors were found to have performed well over the previous 12-month period, each achieving over 80% adult uptake of HIVST within their cluster. All 26 counsellors were invited back to continue their contract, but 1 declined citing other commitments and more lucrative offers and sources of income. Community members identified the following issues as 'failures' of counsellors: a lack of access to test kits on demand or the counsellor not having a sufficient number of kits when requested. This was often due to the unavailability of counsellors in their homes or a counsellor's failure to visit a particular household to offer HIVST services.
Willingness to pay
Willingness to pay details
Linkage to prevention, care and treatment