Factors influencing the performance of community health workers: A qualitative study of Anganwadi Workers from Bihar, India

Autor: Purnima Menon, Aparna John, Nicholas Nisbett, Inka Barnett, Rasmi Avula
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Economics
Family support
Psychological intervention
Social Sciences
Efficiency
Families
Sociology
Medicine and Health Sciences
Psychology
Mental Competency
Human Families
Marketing
Children
Qualitative Research
media_common
Community Health Workers
Multidisciplinary
Animal Behavior
Fraud
Eukaryota
Middle Aged
Plants
Incentive
Psychological Distance
Experimental Organism Systems
Scale (social sciences)
Community health
Educational Status
Medicine
Female
Thematic analysis
Research Article
Adult
Employment
Maternal-Child Health Services
Attitude of Health Personnel
Corruption
media_common.quotation_subject
Science
Maternal-Child Health Centers
India
Jobs
Research and Analysis Methods
Interviews as Topic
Young Adult
Plant and Algal Models
Humans
Grasses
Work Performance
Nutrition
Behavior
Salaries and Fringe Benefits
Role
Organisms
Biology and Life Sciences
Diet
Food
Age Groups
Labor Economics
People and Places
Animal Studies
Population Groupings
Animal Migration
Rice
Business
Delivery of Health Care
Zoology
Finance
Qualitative research
Zdroj: PLoS ONE, Vol 15, Iss 11, p e0242460 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Globally, there remain significant knowledge and evidence gaps around how to support Community Health Worker (CHW) programmes to achieve high coverage and quality of interventions. India’s Integrated Child Development Services scheme employs the largest CHW cadre in the world—Anganwadi Workers (AWWs). However, factors influencing the performance of these workers remain under researched. Lessons from it have potential to impact on other large scale global CHW programmes. A qualitative study of AWWs in the Indian state of Bihar was conducted to identify key drivers of performance in 2015. In-depth interviews were conducted with 30 AWWs; data was analysed using both inductive and deductive thematic analysis. The study adapted and contextualised existing frameworks on CHW performance, finding that factors affecting performance occur at the individual, community, programme and organisational levels, including factors not previously identified in the literature. Individual factors include initial financial motives and family support; programme factors include beneficiaries’ and AWWs’ service preferences and work environment; community factors include caste dynamics and community and seasonal migration; and organisational factors include corruption. The initial motives of the worker (the need to retain a job for family financial needs) and community expectations (for product-oriented services) ensure continued efforts even when her motivation is low. The main constraints to performance remain factors outside of her control, including limited availability of programme resources and challenging relationships shaped by caste dynamics, seasonal migration, and corruption. Programme efforts to improve performance (such as incentives, working conditions and supportive management) need to consider these complex, inter-related multiple determinants of performance. Our findings, including new factors, contribute to the global literature on factors affecting the performance of CHWs and have wide application.
Databáze: OpenAIRE
Externí odkaz: