Role of Community Health Extension Workers in Early Identification of Orthopaedic Complications in Rural Nassarawa State

Community Health Extension Workers (CHEWs) are a critical cadre of Nigeria's primary health workforce, particularly in rural settings where specialist services are inaccessible. Their potential role in early identification of orthopaedic complications including compartment syndrome, cast problems, and wound infections remains underexplored. This mixed-methods study evaluates the knowledge, skills, and current practice of CHEWs in early identification of common orthopaedic complications in rural communities of Nassarawa State, North Central Nigeria. A structured knowledge assessment questionnaire will be administered to 80 CHEWs in four local government areas, complemented by direct observation of fracture patient consultations and key informant interviews with CHEWs and supervising nurses. Thematic analysis of qualitative data and descriptive statistics for quantitative data will be integrated. The study hypothesises that CHEWs lack adequate training in orthopaedic complication recognition, limiting their effectiveness as a referral gateway. Findings will be presented to the Nassarawa State Primary Health Care Development Agency and the National Primary Health Care Development Agency (NPHCDA) to support CHEW training curriculum reform. This research contributes to evidence for task-shifting strategies in orthopaedic care within North Central Nigeria, supporting a more integrated primary care approach to musculoskeletal health. Keywords: community health extension workers, orthopaedic complications, early identification, Nassarawa, primary health care.