ROLE OF NON-MONETARY INCENTIVES ON COMMUNITY HEALTH WORKERS PERFORMANCE IN MAKUENI COUNTY, KENYA

Ruth Gathoni Mbugua, James Mwitari

Abstract


Abstract

Introduction: Community Health Workers were recognized as the cornerstone of comprehensive   during the Alma Ata conference in 1978. CHWs were defined as being able to serve communities in the remote areas and to assist in meeting the unmet demand for health care services across countries. The CHWs would improve acess to health care services among the poor and in the geographically medically underserved regions. Since the implementation of CHW programmes across countries their has been an experience of high attrition rates ranging from 3.2%- 77 % which could be attributed to several factors and low morale among the CHWs.

Methods: A community based Cross-sectional comparative design was used which employed both qualitative and quantitative methods of data collection.

Findings: Receiving of subsequent training, frequency of supervision and number of households served by the CHWs was significantly associated with performance. Majority of CHWs for both groups were satisfied with their job with 40.4% of CHWs not receiving incentives compared to 46.6% among CHWs receiving monetary incentives. Majority of CHWs had ever contemplated dropping off their CHW roles with the major constraints faced by CHWs cited being lack of support of the supervisors and lack of transport.

Conclusion and recommendations: The CHWs performance can be enhanced through subsequent training, harmonization of the training curriculum, setting up of proper supervision mechanisms, harmonization of workload, provision of transport and community support.

 



Keywords


Community Health Workers, Community Units, Performance, Non-Monetary incentives.

Full Text:

PDF

References


Bhattacharyya K, Winch P, LeBan K, Tien M. (2001). Community health worker incentives and disincentives: how they affect motivation, retention and sustainability. Arlington, Virginia, BASICS/USAID.

Brunie, A., Wamala-Mucheri, P., Otterness, C., Akol, A., Chen, M., Bufumbo, L., & Weaver, M. (2014). Keeping community health workers in Uganda motivated: key challenges, facilitators, and preferred program inputs. Global Health, Science and Practice, 2(1), 103–116. http://doi.org/10.9745/GHSP-D-13-00140

Celleti F, Wright A, Palen J, Seble F. (2010).Can the deployment of community health workers for the delivery of HIV services represents an effective and sustainable response to health workforce shortages? Results of a multi country study. World Health Organization publication.

Fazila K. (2010). Community Health Worker Programs: A Review of Recent Literature. Published by University Research Co., LLC for review by the United States Agency for International Development (USAID)

Gisore P, Rono B, Marete I, Nekesa-Mangeni J, Tenge C, Shipala E, et. al., (2013) commonly cited incentives in the community implementation of the emergency maternal and newborn care study in western Kenya. African Health Sciences 2013; 13(2):461 – 468

Haile, F., Yemane, D., & Gebreslassie, A. (2014). Assessment of non-financial incentives for volunteer community health workers – the case of Wukro district, Tigray, Ethiopia. Human Resources for Health, 12, 54. http://doi.org/10.1186/1478-4491-12-54

Kallander K., Tomson G., Nsabagasani, X, Sabiiti, J, Pariyo G., Peterson, S. (2006). Can community health workers and caretakers recognize pneumonia? London: DFID Health Systems Resource Centre.

Kelly J, Osamba B, Garg R, Hamel M, Lewis J, Rowe S, Rowe A, Deming M. (2001). Community health worker performance in the management of multiple childhood illnesses: Siaya District, Kenya, 1997-2001. Am J Public Health, 91(10):1617–1624.

Kenya Demographic and Health Survey 2008-09, Kenya National Bureau of Statistics (KNBS) and ICF Macro. 2010. Calverton, Maryland: KNBS and ICF Macro. Nairobi, Kenya

Kenya National Bureau of Statistics. (2009) Makueni District Multiple Indicator ClusterSurvey 2008. Nairobi Kenya; Kenya National Bureau of Statistics.

Khan SH, Chowdhury AM, Karim F, Barua MK. (1998) Training and retaining shasthyo shebika: reasons for turnover of Community Health Workers in Bangladesh.

Kok, M. C., Dieleman, M., Taegtmeyer, M., Broerse, J. E., Kane, S. S., Ormel, H., de Koning, K. A. (2015). Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review. Health Policy and Planning, 30(9), 1207–1227. http://doi.org/10.1093/heapol/czu126

Miller SJ, Sam Musominali S, Baganizi M, Paccione GA. (2014) A process evaluation of performance-based incentives for village health workers in Kisoro district, Uganda.

Ndedda C, Wamae A, Ndirangu M, David Wamalwa D. (2012) Effects of Selected Socio-Demographic Characteristics of Community Health Workers on Performance of Home Visits during Pregnancy: A Cross-Sectional Study in Busia District, Kenya. Published by Canadian Center of Science and Education.

Ofosu-Amaah, V. (1983). National Experience in the Use of Community Health Workers. A Review of Current Issues and Problems. WHO Offset Publication 71:1–49?

Olang'o C, Nyamongo I, Aagaard-Hansen J. (2010) Staff attrition among Community Health Workers in home-based care programs for people living with HIV and AIDS in western Kenya. Health Policy. 2010 Oct; 97(2-3):232-7 PubMed PMID: 20807685.

Oyore J., Mwitari J, Ouma J, Ndung’u E. (2010). Evaluation report of the Community Health Strategy implementation in Kenya. Ministry of Public Health and Sanitation.

Opiyo R and Njoroge, P. (2009). Review of the Implementation of the Community Health Strategy in Kenya. The World Bank/Ministry of Public Health and Sanitation.

Owek C, Abong’o B, Oyugi H, Oteku J, Kaseje D, Muruka C, Njuguna J,.(2013). Motivational Factors that Influence Retention of Community Health Workers in a Kenyan District. Public Health Research 2013, 3(5): 109-115

Prasad B. M, Muraleedharan V.R. (2007) .Community Health Workers: a review of concepts, practice and policy concerns.

Republic of Kenya, MOH (2006). Taking the Kenya Essential Package for Health to the Community: A Strategy for the Delivery of Level one services. Published by: Ministry of Health.

Republic of Kenya, MOPHS (2006). Community Health Workers’ Training Guide. Nairobi., Kenya. Published by: Ministry of Health.

Republic of Kenya, MOH (2005). Reversing the Trends: The Second National Health Sector Strategic Plan of Kenya –NHSSP II 2005–2010 Published by: Ministry of Health.

Ronsmans C, Vanneste A.M, Chakraborty J, Van Ginneken J. (1997). Decline in maternal mortality in Matlab, Bangladesh: a cautionary tale. Lancet, 350(9094):1810–1814.

Rowe, S. Y., Olewe, M. A., Kleinbaum, D. G., McGowan, J. E., McFarland, D. A., Rochat, R. and Deming, M. S. (2007), Longitudinal analysis of community health workers’ adherence to treatment guidelines, Siaya, Kenya, 1997–2002. Tropical Medicine & International Health, 12: 651–663. doi:10.1111/j.1365-3156.2007.01824.x

World Health Organization. (2008). Task shifting: rational redistribution of tasks among health workforce teams: global recommendations and guidelines. Geneva: WHO.

World Health Organization (2007). Community Health Workers: What do we know about them? The state of the evidence on programs, activities, costs and impact on health outcomes of using community health workers. A report by Uta Lehmann and David Sanders School of Public Health University of the Western Cape, Geneva.


Refbacks

  • There are currently no refbacks.




Copyright (c) 2017 Kenyan Journal of Nursing & Midwifery



© Numid Publishers        ISSN:  2518-8631