# Acceptability and Feasibility of Provision of COVID-19 Services by Community Health Workers to Remote Gold Mining Communities in Suriname

## TL;DR

Community health workers in Suriname successfully provided free and accessible COVID-19 testing in remote gold mining communities, improving health access and testing rates.

## Contribution

Demonstrates the feasibility and acceptance of integrating COVID-19 services into existing community health worker programs in remote areas.

## Key findings

- 1,300 people were tested for COVID-19, with 8% testing positive and 28.7% being women.
- 2.2% of asymptomatic individuals tested positive, showing the value of proactive testing.
- 29% of those tested reported using CHW services for their most recent test, indicating strong community acceptance.

## Abstract

Gold mining communities in the Amazon region typically have limited access to public health services. In Suriname, the Ministry of Health Malaria Program (MoH-MP) works with community health workers (CHWs), people from mining communities without a formal medical degree, to provide malaria diagnostic and treatment services. During the COVID-19 pandemic, the MoH-MP trained 21 of these CHWs in COVID-19 outreach and testing, using rapid antigen tests for symptomatic persons in their communities; afterward, a mixed methods research approach was used to investigate whether including COVID-19 services in the tasks of the CHWs was feasible and accepted among gold mining populations. Also, CHWs took part in active case detection missions to proactively offer COVID-19 testing to all inhabitants of specific mining areas, regardless of symptoms. In the 6 months of field implementation (May–October 2022), 1,300 persons were tested for COVID-19, among whom 28.7% were women. Eight percent tested positive. Of the 312 asymptomatic persons tested, 2.2% tested positive. Qualitative semi-structured interviews with the CHWs and quantitative pre- and postintervention surveys revealed that the communities appreciated the nearby and free COVID-19 testing opportunity. The intervention motivated individuals who otherwise would not have been tested to test for COVID-19. Twenty-nine percent of those who had tested at least once for COVID-19 reported that their most recent test was conducted through the services of the CHWs. The results suggest that integrating COVID-19 testing into other CHW services can lower health access barriers in difficult-to-reach populations in remote communities.