Urban Ghanaian communities face significant health challenges, necessitating effective community health worker (CHW) programmes to bridge service gaps. A mixed-methods approach was employed, including surveys, interviews, and observational studies among urban populations. Statistical models were used to analyse data. CHW programmes showed a moderate adoption rate (65%) across the study areas, with significant variation in performance outcomes related to community engagement. Findings suggest that CHW programme success is influenced by local context and stakeholder support. Further research is recommended to refine intervention strategies. Investment should focus on enhancing CHW training programmes and strengthening community partnerships for sustainable health improvements. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.