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Clin Infect Dis. 2016 Dec 15;63(suppl 5):S270-S275.

Motivation of Community Health Workers in Diagnosing, Treating, and Referring Sick Young Children in a Multicountry Study.

Author information

1
Groupe de Recherche Action en Santé, Ouagadougou, Burkina Faso.
2
Department of Sociology, Faculty of the Social Sciences.
3
Child Health Division, Ministry of Health, Kampala, Uganda.
4
Department of Epidemiology and Medical Statistics.
5
Department of Health Promotion and Education, Faculty of Public Health.
6
Department of Pharmacology and Therapeutics.
7
Epidemiology and Biostatistics Research Unit, Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria.
8
Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, The Netherlands.
9
UNICEF/UNDP/World Bank/WHO/Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.

Abstract

BACKGROUND:

 Community health workers (CHWs) are an important element of care provision for a wide range of conditions, but their turnover rate is high. Many studies have been conducted on health workers' motivation, focusing on formal sector staff but not CHWs. Although CHWs are easy to recruit, motivating and retaining them for service delivery is difficult. This article investigates factors influencing CHW motivation and retention in health service delivery.

METHODS:

 Quantitative and qualitative data were collected to identify the key factors favoring motivation and retention of CHWs as well as those deterring them. We interviewed 47, 25, and 134 CHWs in Burkina Faso, Nigeria, and Uganda, respectively, using a structured questionnaire. Focus group discussions (FGDs) were also conducted with CHWs, community participants, and facility health workers.

RESULTS:

 Except for Burkina Faso, most CHWs were female. Average age was between 38 and 41 years, and most came from agricultural communities. The majority (52%-80%) judged they had a high to very high level of satisfaction, but most CHWs (approximately 75%) in Burkina Faso and Uganda indicated that they would be prepared to leave the job, citing income as a major reason. Community recognition and opportunities for training and supervision were major incentives in all countries, but the volume of unremunerated work, at a time when both malaria-positive cases and farming needs were at their peak, was challenging.

CONCLUSIONS:

 Most CHWs understood the volunteer nature of their position but desired community recognition and modest financial remuneration.

CLINICAL TRIALS REGISTRATION:

 ISRCTN13858170.

KEYWORDS:

Africa; community health worker; motivation; retention; volunteers

PMID:
27941104
PMCID:
PMC5146697
DOI:
10.1093/cid/ciw625
[Indexed for MEDLINE]
Free PMC Article

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