scholarly journals Factors influencing the performance of community health workers: A qualitative study of Anganwadi Workers from Bihar, India

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242460
Author(s):  
Aparna John ◽  
Nicholas Nisbett ◽  
Inka Barnett ◽  
Rasmi Avula ◽  
Purnima Menon
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Large Scale ◽  
Health Workers ◽  
Seasonal Migration ◽  
High Coverage ◽  
Factors Affecting ◽  
Community Factors ◽  
Factors Influencing ◽  
The Individual

Globally, there remain significant knowledge and evidence gaps around how to support Community Health Worker (CHW) programmes to achieve high coverage and quality of interventions. India’s Integrated Child Development Services scheme employs the largest CHW cadre in the world—Anganwadi Workers (AWWs). However, factors influencing the performance of these workers remain under researched. Lessons from it have potential to impact on other large scale global CHW programmes. A qualitative study of AWWs in the Indian state of Bihar was conducted to identify key drivers of performance in 2015. In-depth interviews were conducted with 30 AWWs; data was analysed using both inductive and deductive thematic analysis. The study adapted and contextualised existing frameworks on CHW performance, finding that factors affecting performance occur at the individual, community, programme and organisational levels, including factors not previously identified in the literature. Individual factors include initial financial motives and family support; programme factors include beneficiaries’ and AWWs’ service preferences and work environment; community factors include caste dynamics and community and seasonal migration; and organisational factors include corruption. The initial motives of the worker (the need to retain a job for family financial needs) and community expectations (for product-oriented services) ensure continued efforts even when her motivation is low. The main constraints to performance remain factors outside of her control, including limited availability of programme resources and challenging relationships shaped by caste dynamics, seasonal migration, and corruption. Programme efforts to improve performance (such as incentives, working conditions and supportive management) need to consider these complex, inter-related multiple determinants of performance. Our findings, including new factors, contribute to the global literature on factors affecting the performance of CHWs and have wide application.

scholarly journals Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

2020 ◽  
Author(s):  
Joshua P Murphy ◽  
Aneesa Moolla ◽  
Sharon Kgowedi ◽  
Constance Mongwenyana ◽  
Sithabile Mngadi ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Policy Implementation ◽  
Community Health ◽  
Resource Constraints ◽  
Health Workers ◽  
Healthcare Providers ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

scholarly journals Analysis of Factors Influencing Effective Utilization Coefficient of Irrigation Water in the Manas River Basin

Water ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 189
Author(s):  
Lili Yang ◽  
Tong Heng ◽  
Guang Yang ◽  
Xinchen Gu ◽  
Jiaxin Wang ◽  
...  
Keyword(s):  
Irrigation Water ◽  
Large Scale ◽  
Grey Model ◽  
Analytic Hierarchy ◽  
Effective Utilization ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Utilization Coefficient ◽  
Using Data ◽  
Effective Use

The factors influencing the effective utilization coefficient of irrigation water are not understood well. It is usually considered that this coefficient is lower in areas with large-scale irrigation. With this background, we analyzed the effective utilization coefficient of irrigation water using the analytic hierarchy process using data from 2014 to 2019 in Shihezi City, Xinjiang. The weights of the influencing factors on the effective utilization coefficient of irrigation water in different irrigation areas were analyzed. Predictions of the coefficient’s values for different years were made by understanding the trends based on the grey model. The results show that the scale of the irrigation area is not the only factor determining the effective utilization coefficient of irrigation water. Irrigation technology, organizational integrity, crop types, water price management, local economic level, and channel seepage prevention are the most critical factors affecting the effective use of irrigation water. The grey model prediction results show that the effective utilization coefficient of farmland irrigation water will continuously increase and reach 0.7204 in 2029. This research can serve as a reference for government authorities to make scientific decisions on water-saving projects in irrigation districts in terms of management, operation, and investment.

scholarly journals Predictors of Malaria Rapid Diagnostic Tests’ Utilisation Among Healthcare Workers in Zamfara State

2018 ◽  
Author(s):  
Usman Rabi ◽  
Ahmad A. Umar ◽  
Saheed Gidado ◽  
A.A Gobir ◽  
Izuchukwu F. Obi ◽  
...  
Keyword(s):  
Community Health ◽  
Healthcare Workers ◽  
Health Workers ◽  
Diagnostic Testing ◽  
Study Data ◽  
Good Knowledge ◽  
Health Extension Workers ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Influencing

AbstractIntroductionEarly diagnosis and prompt and effective treatment is one of the pillars of malaria control Malaria case management guidelines recommend diagnostic testing before treatment using malaria Rapid Diagnostic Test (mRDT) or microscopy and this was adopted in Nigeria in 2010. However, despite the deployment of mRDT, the use of mRDTs by health workers varies by settings. This study set out to assess factors influencing utilisation of mRDT among healthcare workers in Zamfara State, Nigeria.MethodsA cross-sectional study was carried out among 306 healthcare workers selected using multistage sampling from six Local Government Areas between January and February 2017. Mixed method was used for data collection. A pre-tested self-administered questionnaire was used to collect information on knowledge, use of mRDT and factors influencing utilization. An observational checklist was used to assess the availability of mRDT in the six months prior to this study. Data were analyzed using descriptive statistics such as means and proportions. Association between mRDT use and independent variables was tested using Chi square while multiple regression was used to determine predictors of use at 5% level of significance.ResultsMean age of respondents was 36.0 ± 9.4years. Overall, 198 (64.7%) of health workers had good knowledge of mRDT; malaria RDT was available in 33 (61.1%) facilities. Routine use of mRDT was reported by 253 (82.7%) healthcare workers. This comprised 89 (35.2%) laboratory scientists/technicians, 89 (35.2%) community health extension workers/community health officers; 59 (23.3%) nurses and 16 (6.3%) doctors. Predictors of mRDT utilisation were good knowledge of mRDT (adjusted OR (aOR):3.3, CI: 1.6-6.7), trust in mRDT results (aOR: 4.0, CI: 1.9 - 8.2), having being trained on mRDT (aOR: 2.7, CI: 1.2 - 6.6), and provision of free mRDT (aOR: 2.3, CI: 1.0 - 5.0).ConclusionThis study demonstrated that healthcare worker utilisation of mRDT was associated with health worker and health system-related factors that are potentially modifiable. There is need to sustain training of healthcare workers on benefits of using mRDT and provision of free mRDT in health facilities.

Motivating and demotivating factors for community health workers: A qualitative study in urban slums of Delhi, India

2017 ◽  
Vol 6 (1) ◽  
pp. 82 ◽  
Author(s):  
MathewSunil George ◽  
Shradha Pant ◽  
Niveditha Devasenapathy ◽  
Suparna Ghosh-Jerath ◽  
SanjayP Zodpey
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Urban Slums

Developing a model for analyzing the factors influencing interpersonal conflict

2019 ◽  
Vol 57 (5) ◽  
pp. 1127-1144
Author(s):  
Zeinab Lalegani ◽  
Ali Nasr Isfahani ◽  
Arash Shahin ◽  
Ali Safari
Keyword(s):  
Qualitative Study ◽  
Mixed Method ◽  
Interpersonal Conflict ◽  
Organizational Factors ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Content Type ◽  
Factors Affecting ◽  
Interpersonal Conflicts ◽  
Factors Influencing

Purpose The purpose of this paper is to develop and analyze a model of factors influencing interpersonal conflicts. Design/methodology/approach This research was conducted using a mixed method approach. In the qualitative study, the conceptual model of the factors affecting interpersonal conflicts was extracted from semi-structured interviews with 17 relevant experts using a theme analysis technique. Then, three hypotheses were developed based on the model and relevant theoretical evidence. Using a researcher-made questionnaire which was developed earlier based on the qualitative results, a quantitative-based survey was performed to assess the interpersonal conflicts and also the standard scale of the level of interpersonal conflicts (Jehn, 1997). The hypotheses were tested on a sample of 160 employees of Chaharmahal and Bakhtiari Province Gas Company (CBPGC). Findings The results of the qualitative study indicated that individual factors including personality dimensions and individual differences; organizational factors including five dimensions of organizational culture, organizational structure, management characteristics, intra-organization factors and human resource systems; and environmental factors influenced the creation of interpersonal conflicts. The results of the quantitative study indicated that organizational factors with an effect size of 0.502 were identified as the most important factor influencing interpersonal conflicts. Research limitations/implications The findings of this study can provide a roadmap to managers of the CBPGC to be aware of the contributing factors to conflict within their organization. Originality/value The use of mixed method to identify the causes and factors of interpersonal conflict and analyzing a context different from previous studies can be considered as the innovations of this study.

scholarly journals Improving the performance of community health workers in Swaziland: findings from a qualitative study

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Pascal Geldsetzer ◽  
Jan-Walter De Neve ◽  
Chantelle Boudreaux ◽  
Till Bärnighausen ◽  
Thomas J. Bossert
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

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