Abstract

This article uses cross-country comparative analysis to explore how community health workers (CHWs) deal with the COVID-19 pandemic. It combines insights from the street-level bureaucracy literature and an interpretive approach with original data from semi-structured interviews with CHWs in Kenya and Thailand. Findings show that how a public health system is organized (decentralization versus centralization) affects CHWs’ initial responses to the outbreak. While CHWs in Thailand’s centralized system conform to the “state agent” tradition by referring to the hierarchical chain of command, those in Kenya’s decentralized system follow the “citizen agent” tradition by prioritizing community safety.

摘要

本文使用跨国比较分析来探索社区卫生工作者（CHW）如何应对COVID-19大流行。它结合了来自街头官僚文学的见解和解释性方法，以及来自肯尼亚和泰国的CHW进行的半结构化访谈的原始数据。研究结果表明，公共卫生系统的组织方式（权力下放与集中）会影响社区卫生工作者对疫情的最初反应。尽管泰国集中式系统中的CHW通过提及等级指挥链来符合“国家特工”的传统，但肯尼亚分散式系统中的CHW则通过优先考虑社区安全来遵循“公民特工”的传统。