abstract: 'Background: Community health workers (CHWs) have been employed in a

  number of low-and middle-income countries as part of primary health care

  strategies, but the packages vary across and even within countries. The

  experiences and motivations of a multipurpose CHW in providing maternal

  and newborn health have not been well described.

  Objective: This study examined the perceptions of community members and

  experiences of CHWs around promoting maternal and newborn care

  practices, and the self-identified factors that influence the

  performance of CHWs so as to inform future study design and programme

  implementation.

  Design: Data were collected using in-depth interviews with six local

  council leaders, ten health workers/CHW supervisors, and eight mothers.

  We conducted four focus group discussions with CHWs. Respondents

  included 14 urban and 18 rural CHWs. Key themes explored included the

  experience of CHWs according to their various roles, and the

  facilitators and barriers they encounter in their work particular to

  provision of maternal and newborn care. Qualitative data were analysed

  using manifest content analysis methods.

  Results: CHWs were highly appreciated in the community and seen as

  important contributors to maternal and newborn health at grassroots

  level. Factors that positively influence CHWs included being selected by

  and trained in the community; being trained in problem-solving skills;

  being deployed immediately after training with participation of local

  leaders; frequent supervision; and having a strengthened and responsive

  supply of services to which families can be referred. CHWs made use of

  social networks to identify pregnant and newly delivered women, and were

  able to target men and the wider family during health education

  activities. Intrinsic motivators (e.g. community appreciation and the

  prestige of being `a doctor''), monetary (such as a small transport

  allowance), and material incentives (e.g. bicycles, bags) were also

  important to varying degrees.

  Conclusions: There is a continued role for CHWs in improving maternal

  and newborn care and linking families with health services. However, the

  process for building CHW programmes needs to be adapted to the local

  setting, including the process of training, deployment, supervision, and

  motivation within the context of a responsive and available health

  system.'
affiliation: 'Okuga, M (Corresponding Author), Makerere Univ, Sch Publ Hlth, Dept
  Hlth Policy Planning \& Management, Coll Hlth Sci, Kampala, Uganda.

  Okuga, Monica; Namutamba, Sarah; Namazzi, Gertrude; Waiswa, Peter, Makerere Univ,
  Sch Publ Hlth, Dept Hlth Policy Planning \& Management, Kampala, Uganda.

  Waiswa, Peter, Karolinska Inst, Dept Publ Hlth Sci, Global Hlth, Stockholm, Sweden.

  Waiswa, Peter, Iganga Mayuge Hlth Demog Surveillance Site, Iganga Mayuge, Uganda.'
article-number: '23968'
author: Okuga, Monica and Kemigisa, Margaret and Namutamba, Sarah and Namazzi, Gertrude
  and Waiswa, Peter
author-email: mokugga@yahoo.com
author_list:
- family: Okuga
  given: Monica
- family: Kemigisa
  given: Margaret
- family: Namutamba
  given: Sarah
- family: Namazzi
  given: Gertrude
- family: Waiswa
  given: Peter
da: '2023-09-28'
doi: 10.3402/gha.v8.23968
files: []
issn: 1654-9880
journal: GLOBAL HEALTH ACTION
keywords: 'newborn health; maternal health; community health worker; pregnancy;

  postnatal care; Uganda'
keywords-plus: 'RANDOMIZED CONTROLLED-TRIAL; RURAL UGANDA; ALMA-ATA; SURVIVAL;

  PERCEPTIONS; MANAGEMENT; PROGRAMS; RESOURCE'
language: English
number-of-cited-references: '24'
papis_id: 0d4c99aa6fe83ad7eeeaecf4ce22074e
ref: Okuga2015engagingcommunity
times-cited: '36'
title: Engaging community health workers in maternal and newborn care in eastern Uganda
type: Article
unique-id: WOS:000377748300001
usage-count-last-180-days: '0'
usage-count-since-2013: '11'
volume: '8'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2015'