Community Health Volunteers in Primary Healthcare in Rural Uganda: Factors Influencing Performance
| Autor: | Yusufu Kuule, Ewan Wilkinson, Nahabwe Haven, Philip Owiti, Robinah Najjemba, Desalegn Woldeyohannes, Birungi Mutahunga R. Edwin, Maria Zolfo, Andrew E. Dobson, Kristien Verdonck |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
universal health coverage 03 medical and health sciences community health workers 0302 clinical medicine Health facility Environmental health Medicine 030212 general & internal medicine Bwindi Under-five business.industry 030503 health policy & services Public health Public Health Environmental and Occupational Health Attendance operational research Odds ratio sustainable development goals medicine.disease Community hospital Malnutrition SORT IT health system strengthening Community health Public Health 0305 other medical science business Community Case Study |
| Zdroj: | Frontiers in Public Health |
| ISSN: | 2296-2565 |
| DOI: | 10.3389/fpubh.2017.00062 |
| Popis: | Introduction Community health volunteers (CHVs) play an integral role in primary healthcare. Several countries rely on CHV programs as a major element in improving access to care and attaining universal health coverage. However, their performance has been heterogeneous and at times context-specific, and influenced by multiple factors. We describe the socio-demographic and workplace characteristics affecting CHVs’ performance in a public health program in rural western Uganda. Methods This was a cross-sectional study based on routine program data of CHVs serving the catchment of Bwindi Community Hospital, Kanungu District, South Western Uganda, in 2014 and 2015. Information was collected on individual socio-demographic and workplace characteristics of the CHVs. To assess their work output, we defined study-specific targets in terms of attendance at monthly CHVs’ meetings with community health nurses, households followed-up and reported, children screened for malnutrition, immunization coverage, and health facility deliveries. Frequencies and proportions are reported for characteristics and outputs and odds ratios for study-specific factors associated with overall performance. Results Of the 508 CHVs, 65% were women, 48% were aged 35 years and below, and 37% took care of more than the recommended 20–30 households. Seventy-eight percent of the CHVs had ≥80% of pregnant women under their care delivering in health units, 71% had ≥95% of the children on schedule for routine immunization, while 27% screened ≥75% of the children under 5 years for malnutrition. More refresher trainings was associated with better overall performance [adjusted odds ratio (aOR): 12.2, 95% confidence interval (CI): 1.6–93.6, P = 0.02] while overseeing more than the recommended 20–30 households reduced overall performance (aOR: 0.6, 95% CI: 0.4–0.9, P = 0.02). Conclusion Being in-charge of more than the recommended households was associated with reduced performance of CHVs, while more refresher trainings were associated with improved performance. If the CHVs are to remain a strategic pillar in universal health coverage, it is imperative to address those factors known to impact on their performance. |
| Databáze: | OpenAIRE |
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