Performance of Community Health Workers for Water Quality, Hygiene, and Sanitation of Households in the Comè-Bopa-GrandPopo-Houéyogbé Health Zone in Benin

Objectives: This study aimed to measure the performance of community health workers in carrying out activities for water quality, hygiene, and sanitation in the Comè-Bopa-Grand-Popo-Houéyogbé health zone in Benin. Methods: A cross-sectional analytical survey was conducted among 640 randomly selected households and 160 community health workers (CHW) covering these households. Data collection was carried out through interviews and observations, questionnaire, and observation grid. Statistical analysis was carried out using SPSS 21.0 for a descriptive analysis of sociodemographic, health, and environmental variables. Results: The results show that 95.5% of households were aware of the CHW, and 89.5% had received a visit in the last three months. The main actions of the CHW concerned hygiene (85.2%), malaria control (68.9%), and vaccination (46.9%). The performance of the CHW, assessed in 160 of them, was considered acceptable in 50.6% of cases, poor in 43.1%, and good in only 6.3%. Analysis of associated factors shows that training on the activity package was significantly linked to better performance of community health workers (OR = 2.5; 95% CI: 1.1 - 7.0; p = 0.03). Conclusions: The study highlights a positive impact of CHW on the adoption of good hygiene and disease prevention practices. However, efforts are still needed to strengthen their logistical support and increase awareness of water treatment and sanitation. Although CHW improve hygiene practices, their effectiveness remains limited. Strengthening training and logistical support is crucial to maximizing their impact.