| Popis: |
Community Health Workers (CHWs) and Community Health Volunteers (CHVs), lay persons who have received some training to deliver health care services but are not professionals, have been found to contribute in a variety of capacities to bridge gaps in health systems in some countries specifically by undertaking interventions that improve maternal and under-5 outcomes. Supervision has been acknowledged as an important, but often neglected, component of effective CHW and CHV programs. To explore supervision of part-time CHVs by full-time CHWs a mixed-methods study was conducted in eight villages in Budondo, Uganda from March 2014 to February 2015. The quantitative component involved a pair-matched cluster randomised trial. After conducting a baseline household survey (n=216) and focus groups with community members, 82 volunteer CHVs were selected from the eight study villages. The CHVs from all villages received monthly in-village training from four full-time CHWs. Each CHV made home-visits about pregnancy, new-born care and hygiene. The CHVs from the four intervention villages received additional monthly supervision and accompaniment from the full-time CHWs. CHVs were interviewed at the beginning and end of the study. A post-intervention household survey (n=201) was conducted one year after the baseline survey. There was 100% retention of full-time CHWs at the end of one year and a 95% retention rate of CHVs in both the intervention and the control groups during the same period. Trust, working in pairs, accompaniment, relationship building in the community and knowledge gained were found to be important in both CHW and CHV motivation and community engagement. The final household survey showed a significantly higher percentage of households with tippy taps built in intervention villages (47%) than the control villages (35%) (p |
