DETERMINANTS OF KNOWLEDGE, ATTITUDE, AND PRACTICE LEVEL AMONG COMMUNITY HEALTH WORKERS: A SCOPING REVIEW

Abstract

Background: Community Health Workers (CHWs) play a vital role as frontline actors in strengthening public health delivery within primary healthcare systems. Beyond program implementation, CHWs contribute significantly to health literacy promotion and preventive health behaviors at the community level. However, variations in knowledge, attitude, and practice (KAP), shaped by individual, social, and structural factors, influence their effectiveness in delivering community-based health interventions. Understanding these determinants is essential for strengthening primary healthcare, particularly in developing countries such as Indonesia. Objective: This study aimed to map the key factors influencing the knowledge, attitude, and practice (KAP) of community health workers in primary healthcare settings. Methods: This study employed a scoping review design based on the Arksey and O’Malley framework and guided by the PRISMA-ScR guideline. The review followed the Population, Concept, and Context (PCC) approach. Literature searches were conducted in PubMed, Scopus, and ScienceDirect for studies published between 2019 and 2024, complemented by gray literature. The review process included systematic screening, data charting, thematic synthesis, and expert consultation to ensure methodological rigor. Results: A total of 246 articles were identified, of which seven met the inclusion criteria for final analysis. The synthesis revealed four key determinants influencing CHWs’ KAP: (1) continuous training and education, (2) social capital and community support, (3) individual and contextual characteristics, and (4) utilization of digital technology. Conclusion: Enhancing the KAP of CHWs requires a comprehensive, multi-level approach integrating continuous capacity building, digital literacy development, and supportive social and policy environments. This review highlights the strategic importance of technology-based training and cross-sectoral collaboration in strengthening the role of CHWs within Indonesia’s primary healthcare system and similar community health contexts.