Community Health Worker Training's Impact on Immunization Coverage in Rural Rwanda: A Two-Year Study

Rwanda has made significant progress in reducing child mortality rates through various public health interventions. However, rural areas often face challenges in maintaining high immunization coverage levels. A mixed-methods approach was employed, including baseline and endline surveys, focus group discussions, and CHW observations. Data were collected from 10 health districts across Rwanda. CHWs reported increased confidence and improved communication skills post-training, leading to a statistically significant increase in immunization coverage rates by an average of 25% compared to pre-training levels (95% CI: [18%, 34%]). Training CHWs significantly enhanced their ability to promote vaccination adherence among rural populations. Rural health authorities should prioritise ongoing training and support for CHWs, focusing on vaccine efficacy education and community engagement strategies. Community Health Workers, Rural Rwanda, Immunization Coverage, Training Effectiveness Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.