Performance of female volunteer community health workers in Dhaka urban slums
Performance of female volunteer community health workers in Dhaka urban slums
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DOI：
10.1016/j.socscimed.2012.03.039
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发表时间：
2012-08-01
影响因子：
5.4
通讯作者：
Oliveras, Elizabeth
中科院分区：
文献类型：
--
作者：
Alam, Khurshid;Tasneem, Sakiba;Oliveras, Elizabeth
志愿社区卫生工作者是解决发展中国家卫生人力危机的一种方法。孟加拉国的一个大型非政府组织BRAC是这一领域的先驱，它使用女性志愿者社区卫生工作者作为其卫生方案的核心工作者。在农村地区实施社区卫生工作者模式25年后，农村促进委员会开始通过其基于社区的母亲、新生儿和儿童保健干预措施，在城市贫民窟使用女性社区卫生工作者。然而，该计划在社区卫生工作者中的表现并不理想，其中很高比例的人留在自己的职位上，但变得“不活跃”，没有真正参与日常社区卫生活动。这表明有必要更好地了解影响他们积极参与的因素的相对重要性，并建议改善他们参与的战略。这项混合方法的研究包括一个描述性的相关设计，以评估相关因素的活动水平的CHW和焦点小组讨论，以探讨解决这些问题。来自项目地区的542名现任女性社区卫生工作者参加了调查。财政奖励是与社区卫生工作者活动有关的主要因素。那些认为没有CHW收入就很难养家的CHW有三倍多的机会变得积极。此外，社会声望和积极的社区反馈的社区卫生工作者的重要非经济因素与活动水平。为了提高社区卫生工作者志愿者的绩效，应采用财政和非财政激励相结合的方式。(C)2012爱思唯尔有限公司保留所有权利。
Volunteer community health workers (CHWs) are one approach to addressing the health workforce crisis in developing countries. BRAC, a large Bangladeshi NGO, a pioneer in this area, uses female volunteer CHWs as core workers in its health programs. After 25 years of implementing the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through its community-based mother, newborn and child health interventions. However, the program experienced suboptimal performance among CHWs, with a high percentage of them remaining in their positions but becoming "inactive", not truly participating in daily community health activities. This suggests a need to better understand the relative importance of factors affecting their active participation and to recommend strategies for improving their participation. This mixed-method study included a descriptive correlational design to assess factors relating to level of activity of CHWs and focus group discussions to explore solutions to these problems. A sample of 542 current female CHWs from project areas participated in the survey. Financial incentives were the main factor linked to the activity of CHWs. CHWs who thought that running their families would be difficult without CHW income had more than three times greater odds to become active. In addition, social prestige and positive community feedback to the CHWs were important non-financial factors associated with level of activity. In order to improve volunteer CHWs' performance, a combination of financial and non-financial incentives should be used. (C) 2012 Elsevier Ltd. All rights reserved.