2023-09-28 14:46:10 +00:00
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abstract: 'Background: Community health workers (CHWs) are increasingly being used
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in low-income countries to address human resources shortages, yet there
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remain few effective, evidence-based strategies for addressing the
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enduring programmatic constraints of worker motivation, retention and
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performance. This paper describes how two interventions were designed by
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the Innovations at Scale for Community Access and Lasting Effects
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(inSCALE) project to address these constraints in Uganda and Mozambique
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drawing on behavioural theory and formative research results.
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Methods: A review of the work motivation and CHW motivation
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literature-incorporating influences on retention and performance-was
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conducted on articles sourced through electronic web searches. Formative
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research with a focus on the barriers and facilitators to CHW
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motivation, retention and performance was conducted with community
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health workers and key stakeholders in Uganda and Mozambique. An
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analytical induction approach to the thematic analysis of transcripts
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from 98 in-depth interviews and 26 focus group discussions was adopted
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across the country settings.
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Results: From the theoretical review, it was determined that the
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interventions should promote CHWs as members of a collective by
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highlighting a sense of shared experience, focus on alignment between
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worker and programme goals, and emphasise the actions that lead to good
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performance. The Social Identity Approach was selected as the theory
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most likely to lead to the development of effective, scalable and
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sustainable interventions by addressing the identified gap in the
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literature of the influence of CHW working context. The formative
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research indicated that CHWs value feedback and feeling connected to the
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health system and their community, are motivated by status and community
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standing, and want to be provided with the necessary tools to perform.
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Two interventions based on these results were developed: a
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participatory, local community approach and an information communication
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technology (ICT) approach.
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Conclusions: Drawing on contextual data and theory that is sensitive to
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context can potentially lead to the development of appropriate and
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effective interventions when aiming to improve the motivation, retention
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and performance of CHWs in Uganda and Mozambique and other comparable
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settings. Evaluation of the developed interventions is crucial to assess
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this potential.'
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affiliation: 'Strachan, DL (Corresponding Author), UCL Inst Global Hlth, 30 Guilford
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St, London WC1N 1EH, England.
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Strachan, Daniel Llywelyn; Hill, Zelee, UCL Inst Global Hlth, London WC1N 1EH, England.
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Kallander, Karin, Malaria Consortium, London EC2A 4LT, England.
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Kallander, Karin, Karolinska Inst, Stockholm, Sweden.
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Nakirunda, Maureen, Malaria Consortium Uganda, Kampala, Uganda.
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Ndima, Sozinho; Muiambo, Abel, Malaria Consortium Mozamb, Coop, Maputo, Mozambique.'
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article-number: '25'
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author: 'Strachan, Daniel Llywelyn and Kallander, Karin and Nakirunda, Maureen and
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Ndima, Sozinho and Muiambo, Abel and Hill, Zelee and inSCALE Study Grp, '
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author-email: d.strachan@ucl.ac.uk
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author_list:
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- family: Strachan
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given: Daniel Llywelyn
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- family: Kallander
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given: Karin
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- family: Nakirunda
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given: Maureen
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- family: Ndima
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given: Sozinho
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- family: Muiambo
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given: Abel
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- family: Hill
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given: Zelee
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- family: inSCALE Study Grp
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given: ''
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da: '2023-09-28'
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doi: 10.1186/s12960-015-0020-8
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eissn: 1478-4491
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files: []
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journal: HUMAN RESOURCES FOR HEALTH
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keywords: 'Community health workers; Motivation; Retention; Performance; Social
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Identity Approach; Human resources for health; Uganda; Mozambique'
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keywords-plus: SOCIAL IDENTITY; PUBLIC-HEALTH; CARE; IDENTIFICATION; PERCEPTIONS;
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POOR
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language: English
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month: APR 30
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number-of-cited-references: '52'
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orcid-numbers: 'Strachan, Daniel/0000-0001-6143-1742
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Soremekun, Seyi/0000-0002-5531-0220
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Kallander, Karin/0000-0002-5778-5780
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Ndima, Sozinho/0000-0003-4650-379X
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Kirkwood, Betty/0000-0001-5274-6072'
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papis_id: e277d5275e03469628452309488420f4
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ref: Strachan2015usingtheory
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times-cited: '46'
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title: Using theory and formative research to design interventions to improve community
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health worker motivation, retention and performance in Mozambique and Uganda
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000354173900001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '20'
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volume: '13'
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web-of-science-categories: Health Policy \& Services; Industrial Relations \& Labor
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year: '2015'
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