Evaluating the Competency and Readiness of Frontline Community Health Extension Workers in Managing Emergency Public Health Crisis Situations

Abstract

Background: Community Health Extension Workers (CHEWs) constitute the primary frontline
infrastructure for delivery within peripheral networks, serving as the first line of defense during
acute public health emergencies. Objective: This investigation executed an empirical assessment
of the professional clinical competencies, logistical readiness parameters, and institutional
challenges experienced by practicing CHEWs when managing emergent epidemiological crises
within Rivers State, Nigeria. Methodology: Utilizing a descriptive cross-sectional survey design,
the study sampled 120 practicing CHEWs across randomly selected primary health facilities. Data
collection was implemented via a validated, high-density multi-stage Clinical Safety and Crisis
Competency Matrix Questionnaire, and analytical results were processed through descriptive and
inferential statistical algorithms. Results: Quantified metrics revealed that while baseline routine
maternal and preventative care proficiencies were high (84.2%), critical competency gaps
manifested in acute infection triage execution (41.7%) and rapid epidemiological data reporting
tracking (31.5%). Operational readiness was heavily hindered by systemic resource gaps,
including deficient supplies of personal protective equipment (87.5%) and an absence of in-service
simulation laboratory training (93.3%). Conclusion: Health science training institutions and
ministry management boards must urgently integrate advanced crisis pedagogy, formalized
objective structured clinical evaluations (OSCEs), and structured supply loops to preserve primary
health security.