Factors affecting the performance of community health workers in India: a multi-stakeholder perspective.
Factors affecting the performance of community health workers in India: a multi-stakeholder perspective.
复制标题
影响印度社区卫生工作者表现的因素：一种多利益相关者的观点。
DOI：
10.3402/gha.v7.25352
复制
发表时间：
2014
影响因子：
2.6
通讯作者：
Bhattacharyya S
中科院分区：
文献类型：
--
作者：
Sharma R;Webster P;Bhattacharyya S
在一些国家，社区卫生工作者(CHW)构成了社区和卫生部门之间的重要纽带。在印度，自2005年以来，这一角色主要由认可的社会卫生积极分子(ASHA)发挥，他们是村级女工。虽然ASHA主要为卫生部门工作，但在拉贾斯坦邦正在测试的一种模式中，它们支持两个政府部门。本文着眼于阿莎在这一新角色中作为两个部门之间的纽带工作者，从多方利益相关者的角度考察了与她的工作绩效相关的因素。这项研究是在拉贾斯坦邦乌代布尔地区两个行政区块的16个村庄进行的。这一发现是基于对ASHA及其同事和两个部门的代表进行的63次深入访谈得出的。采访是根据采访指南进行的。采用开放式编码的归纳法进行人工数据分析。这项研究表明，阿莎的动机和表现受到她工作所处的复杂环境中出现的各种因素的影响。这些因素包括各种个人因素(例如教育)、专业因素(例如培训、工作保障)、组织因素(例如基础设施)以及外部工作环境中出现的其他因素。与会者提出了应对这些挑战的各种方法。为了改善助理署长的表现，除了优先在专业和组织层面采取纠正行动外，促进助理署长和两个部门其他社区工作人员之间的友好工作关系也同样重要。这也将对社区健康产生积极影响。
Community health workers (CHWs) form a vital link between the community and the health department in several countries. In India, since 2005 this role is largely being played by Accredited Social Health Activists (ASHAs), who are village-level female workers. Though ASHAs primarily work for the health department, in a model being tested in Rajasthan they support two government departments. Focusing on the ASHA in this new role as a link worker between two departments, this paper examines factors associated with her work performance from a multi-stakeholder perspective. The study was done in 16 villages from two administrative blocks of Udaipur district in Rajasthan. The findings are based on 63 in-depth interviews with ASHAs, their co-workers and representatives from the two departments. The interviews were conducted using interview guides. An inductive approach with open coding was used for manual data analysis. This study shows that an ASHA's motivation and performance are affected by a variety of factors that emerge from the complex context in which she works. These include various personal (e.g. education), professional (e.g. training, job security), and organisational (e.g. infrastructure) factors along with others that emerge from external work environment. The participants suggested various ways to address these challenges. In order to improve the performance of ASHAs, apart from taking corrective actions at the professional and organisational front on a priority basis, it is equally essential to promote cordial work relationships amongst ASHAs and other community-level workers from the two departments. This will also have a positive impact on community health.