Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya
Abstract Background A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare coverage, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ab...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Human Resources for Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12960-021-00645-5 |
| _version_ | 1818681665255374848 |
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| author | Njeri Nyanja Nelson Nyamu Lucy Nyaga Sophie Chabeda Adelaide Lusambili Marleen Temmerman Michaela Mantel Anthony Ngugi |
| author_facet | Njeri Nyanja Nelson Nyamu Lucy Nyaga Sophie Chabeda Adelaide Lusambili Marleen Temmerman Michaela Mantel Anthony Ngugi |
| author_sort | Njeri Nyanja |
| collection | DOAJ |
| description | Abstract Background A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare coverage, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ability to earn a livelihood is compromised by the voluntary nature of their work; hence, the high attrition rates from community-based health programmes. There is an urgent need to support CHVs become economically self-reliant. We report here on the application of the Ultra-Poverty Graduation (UPG) Model to map CHVs’ preferences for socio-economic empowerment strategies that could enhance their retention in a rural area in Kenya. Methods This study adopted an exploratory qualitative approach. Using a semi-structured questionnaire, we conducted 10 Focus Group Discussions with the CHVs and 10 Key Informant Interviews with County and Sub-county Ministry of Health and Ministry of Agriculture officials including multi-lateral stakeholders’ representatives from two sub-counties in the area. Data were audio-recorded and transcribed verbatim and transcripts analysed in NVivo. Researcher triangulation supported the first round of analysis. Findings were mapped and interpreted using a theory-driven analysis based on the six-step Ultra-Poverty Graduation Model. Results We mapped the UPG Model’s six steps onto the results of our analyses as follows: (1) initial asset transfer of in-kind goods like poultry or livestock, mentioned by the CHVs as a necessary step; (2) weekly stipends with consumption support to stabilise consumption; (3) hands-on training on how to care for assets, start and run a business based on the assets transferred; (4) training on and facilitation for savings and financial support to build assets and instil financial discipline; (5) healthcare provision and access and finally (6) social integration. These strategies were proposed by the CHVs to enhance economic empowerment and aligned with the UPG Model. Conclusion These results provide a user-defined approach to identify and assess strategic needs of and approaches to CHVs’ socio-economic empowerment using the UPG model. This model was useful in mapping the findings of our qualitative study and in enhancing our understanding on how these needs can be addressed in order to economically empower CHVs and enhance their retention in our setting. |
| first_indexed | 2024-12-17T10:06:33Z |
| format | Article |
| id | doaj.art-f00412d462a84452bcff884ee0633506 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-12-17T10:06:33Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj.art-f00412d462a84452bcff884ee06335062022-12-21T21:53:10ZengBMCHuman Resources for Health1478-44912021-08-0119111010.1186/s12960-021-00645-5Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, KenyaNjeri Nyanja0Nelson Nyamu1Lucy Nyaga2Sophie Chabeda3Adelaide Lusambili4Marleen Temmerman5Michaela Mantel6Anthony Ngugi7Department of Family Medicine, Aga Khan UniversityDepartment of Family Medicine, Aga Khan UniversityCentre of Excellence for Women and Child Health, Aga Khan UniversityKenya Medical Research InstituteDepartment of Population Health, Aga Khan UniversityCentre of Excellence for Women and Child Health, Aga Khan UniversityCentre of Excellence for Women and Child Health, Aga Khan UniversityDepartment of Population Health, Aga Khan UniversityAbstract Background A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare coverage, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ability to earn a livelihood is compromised by the voluntary nature of their work; hence, the high attrition rates from community-based health programmes. There is an urgent need to support CHVs become economically self-reliant. We report here on the application of the Ultra-Poverty Graduation (UPG) Model to map CHVs’ preferences for socio-economic empowerment strategies that could enhance their retention in a rural area in Kenya. Methods This study adopted an exploratory qualitative approach. Using a semi-structured questionnaire, we conducted 10 Focus Group Discussions with the CHVs and 10 Key Informant Interviews with County and Sub-county Ministry of Health and Ministry of Agriculture officials including multi-lateral stakeholders’ representatives from two sub-counties in the area. Data were audio-recorded and transcribed verbatim and transcripts analysed in NVivo. Researcher triangulation supported the first round of analysis. Findings were mapped and interpreted using a theory-driven analysis based on the six-step Ultra-Poverty Graduation Model. Results We mapped the UPG Model’s six steps onto the results of our analyses as follows: (1) initial asset transfer of in-kind goods like poultry or livestock, mentioned by the CHVs as a necessary step; (2) weekly stipends with consumption support to stabilise consumption; (3) hands-on training on how to care for assets, start and run a business based on the assets transferred; (4) training on and facilitation for savings and financial support to build assets and instil financial discipline; (5) healthcare provision and access and finally (6) social integration. These strategies were proposed by the CHVs to enhance economic empowerment and aligned with the UPG Model. Conclusion These results provide a user-defined approach to identify and assess strategic needs of and approaches to CHVs’ socio-economic empowerment using the UPG model. This model was useful in mapping the findings of our qualitative study and in enhancing our understanding on how these needs can be addressed in order to economically empower CHVs and enhance their retention in our setting.https://doi.org/10.1186/s12960-021-00645-5Community health volunteers (CHVs)KenyaSocio-economic empowermentUltra-Poverty Graduation Model (UPG)Qualitative |
| spellingShingle | Njeri Nyanja Nelson Nyamu Lucy Nyaga Sophie Chabeda Adelaide Lusambili Marleen Temmerman Michaela Mantel Anthony Ngugi Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya Human Resources for Health Community health volunteers (CHVs) Kenya Socio-economic empowerment Ultra-Poverty Graduation Model (UPG) Qualitative |
| title | Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya |
| title_full | Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya |
| title_fullStr | Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya |
| title_full_unstemmed | Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya |
| title_short | Application of the Ultra-Poverty Graduation Model in understanding community health volunteers’ preferences for socio-economic empowerment strategies to enhance retention: a qualitative study in Kilifi, Kenya |
| title_sort | application of the ultra poverty graduation model in understanding community health volunteers preferences for socio economic empowerment strategies to enhance retention a qualitative study in kilifi kenya |
| topic | Community health volunteers (CHVs) Kenya Socio-economic empowerment Ultra-Poverty Graduation Model (UPG) Qualitative |
| url | https://doi.org/10.1186/s12960-021-00645-5 |
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