Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program
Background Uganda’s community health worker (CHW) program experiences several challenges related to the appropriate motivation, job satisfaction, and performance of the CHW workforce. This study aims to identify barriers in the effective implementation of financial and non-financial incentives to s...
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2022-12-01
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| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | https://www.ijhpm.com/article_4246_36334ce4110708b30ed4ad55f36590cd.pdf |
| _version_ | 1811158699141496832 |
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| author | Shivani Pandya Mukesh Hamal Timothy Abuya Richard Kintu Daniel Mwanga Charlotte E. Warren Smisha Agarwal |
| author_facet | Shivani Pandya Mukesh Hamal Timothy Abuya Richard Kintu Daniel Mwanga Charlotte E. Warren Smisha Agarwal |
| author_sort | Shivani Pandya |
| collection | DOAJ |
| description | Background Uganda’s community health worker (CHW) program experiences several challenges related to the appropriate motivation, job satisfaction, and performance of the CHW workforce. This study aims to identify barriers in the effective implementation of financial and non-financial incentives to support CHWs and to strengthen Uganda’s CHW program.Methods The study was implemented in Uganda’s Lira, Wakiso, and Mayuge districts in May 2019. Ten focus group discussions (FGDs) were held with 91 CHWs, 17 in-depth interviews (IDIs) were held with CHW supervisors, and 7 IDIs were held with policy-level stakeholders. Participants included stakeholders from both the Ugandan government and non-governmental organizations (NGOs). Utilizing a thematic approach, themes around motivation, job satisfaction, incentive preferences, and CHW relationships with the community, healthcare facilities, and government were analyzed. Results CHWs identified a range of factors that contributed to their motivation or demotivation. Non-monetary factors included recognition from the health system and community, access to transportation, methods for identification as a healthcare worker, provision of working tools, and training opportunities. Monetary factors included access to monthly stipends, transportation-related refunds, and timely payment systems to reduce refund delays to CHWs. Additionally, CHWs indicated wanting to be considered for recruitment into the now-halted rollout of a salaried CHW cadre, given the provision of payment.Conclusion It is imperative to consider how to best support the current CHW program prior to the introduction of new cadres, as it can serve to exacerbate tensions between cadres and further undermine provision of community health. Providing a harmonized, balanced, and uniform combination of both monetary incentives with non-monetary incentives is vital for effective CHW programs. |
| first_indexed | 2024-04-10T05:28:33Z |
| format | Article |
| id | doaj.art-f12932c026b44320bcce0db0f6c46e2f |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-10T05:28:33Z |
| publishDate | 2022-12-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-f12932c026b44320bcce0db0f6c46e2f2023-03-07T09:12:01ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392022-12-0111122886289410.34172/ijhpm.2022.62194246Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker ProgramShivani Pandya0Mukesh Hamal1Timothy Abuya2Richard Kintu3Daniel Mwanga4Charlotte E. Warren5Smisha Agarwal6Department of International Health, the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USADepartment of International Health, the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAPopulation Council, Nairobi, KenyaLast Mile Health, Kampala, UgandaPopulation Council, Nairobi, KenyaPopulation Council, Washington, DC, USADepartment of International Health, the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USABackground Uganda’s community health worker (CHW) program experiences several challenges related to the appropriate motivation, job satisfaction, and performance of the CHW workforce. This study aims to identify barriers in the effective implementation of financial and non-financial incentives to support CHWs and to strengthen Uganda’s CHW program.Methods The study was implemented in Uganda’s Lira, Wakiso, and Mayuge districts in May 2019. Ten focus group discussions (FGDs) were held with 91 CHWs, 17 in-depth interviews (IDIs) were held with CHW supervisors, and 7 IDIs were held with policy-level stakeholders. Participants included stakeholders from both the Ugandan government and non-governmental organizations (NGOs). Utilizing a thematic approach, themes around motivation, job satisfaction, incentive preferences, and CHW relationships with the community, healthcare facilities, and government were analyzed. Results CHWs identified a range of factors that contributed to their motivation or demotivation. Non-monetary factors included recognition from the health system and community, access to transportation, methods for identification as a healthcare worker, provision of working tools, and training opportunities. Monetary factors included access to monthly stipends, transportation-related refunds, and timely payment systems to reduce refund delays to CHWs. Additionally, CHWs indicated wanting to be considered for recruitment into the now-halted rollout of a salaried CHW cadre, given the provision of payment.Conclusion It is imperative to consider how to best support the current CHW program prior to the introduction of new cadres, as it can serve to exacerbate tensions between cadres and further undermine provision of community health. Providing a harmonized, balanced, and uniform combination of both monetary incentives with non-monetary incentives is vital for effective CHW programs.https://www.ijhpm.com/article_4246_36334ce4110708b30ed4ad55f36590cd.pdfcommunity health workersincentivesugandaretentionprimary healthcarecommunity health programs |
| spellingShingle | Shivani Pandya Mukesh Hamal Timothy Abuya Richard Kintu Daniel Mwanga Charlotte E. Warren Smisha Agarwal Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program International Journal of Health Policy and Management community health workers incentives uganda retention primary healthcare community health programs |
| title | Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program |
| title_full | Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program |
| title_fullStr | Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program |
| title_full_unstemmed | Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program |
| title_short | Understanding Factors That Support Community Health Worker Motivation, Job Satisfaction, and Performance in Three Ugandan Districts: Opportunities for Strengthening Uganda’s Community Health Worker Program |
| title_sort | understanding factors that support community health worker motivation job satisfaction and performance in three ugandan districts opportunities for strengthening uganda s community health worker program |
| topic | community health workers incentives uganda retention primary healthcare community health programs |
| url | https://www.ijhpm.com/article_4246_36334ce4110708b30ed4ad55f36590cd.pdf |
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