eprintid: 23527
rev_number: 12
eprint_status: archive
userid: 1589
dir: disk0/00/02/35/27
datestamp: 2017-09-27 16:34:30
lastmod: 2024-05-09 07:34:20
status_changed: 2017-09-27 16:34:30
type: article
metadata_visibility: show
creators_name: Geldsetzer, Pascal
creators_name: De Neve, Jan-Walter
creators_name: Boudreaux, Chantelle
creators_name: Bärnighausen, Till
creators_name: Bossert, Thomas J.
title: Improving the performance of community health workers in Swaziland: findings from a qualitative study
subjects: ddc-610
divisions: i-912800
abstract: Background: The performance of community health workers (CHWs) in Swaziland has not yet been studied despite the existence of a large national CHW program in the country. This qualitative formative research study aimed to inform the design of future interventions intended to increase the performance of CHW programs in Swaziland. Specifically, focusing on four CHW programs, we aimed to determine what potential changes to their program CHWs and CHW program managers perceive as likely leading to improved performance of the CHW cadre.   
Methods: The CHW cadres studied were the rural health motivators, mothers-to-mothers (M2M) mentors, HIV expert clients, and a community outreach team for HIV. We conducted semi-structured, face-to-face qualitative interviews with all (15) CHW program managers and a purposive sample of 54 CHWs. Interview transcripts were analyzed using conventional content analysis to identify categories of changes to the program that participants perceived would result in improved CHW performance.  
Results: Across the four cadres, participants perceived the following four changes to likely lead to improved CHW performance: (i) increased monetary compensation of CHWs, (ii) a more reliable supply of equipment and consumables, (iii) additional training, and (iv) an expansion of CHW responsibilities to cover a wider array of the community’s healthcare needs. The supervision of CHWs and opportunities for career progression were rarely viewed as requiring improvement to increase CHW performance.   
Conclusions: While this study is unable to provide evidence on whether the suggested changes would indeed lead to improved CHW performance, these views should nonetheless inform program reforms in Swaziland because CHWs and CHW program managers are familiar with the day-to-day operations of the program and the needs of the target population. In addition, program reforms that agree with their views would likely experience a higher degree of buy-in from these frontline health workers.
date: 2017
publisher: Biomed Central
id_scheme: DOI
ppn_swb: 1656709376
own_urn: urn:nbn:de:bsz:16-heidok-235276
language: eng
bibsort: GELDSETZERIMPROVINGT2017
full_text_status: public
publication: Human resources for health
volume: 15
number: 68
place_of_pub: London
pagerange: 1-9
issn: 1478-4491
citation:   Geldsetzer, Pascal ; De Neve, Jan-Walter ; Boudreaux, Chantelle ; Bärnighausen, Till ; Bossert, Thomas J.  (2017) Improving the performance of community health workers in Swaziland: findings from a qualitative study.  Human resources for health, 15 (68).  pp. 1-9.  ISSN 1478-4491     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/23527/1/12960_2017_Article_236.pdf