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Factors affecting recruitment and retention of community health workers in a newborn care intervention in Bangladesh.

Rahman SM, Ali NA, Jennings L, Seraji MH, Mannan I, Shah R, Al-Mahmud AB, Bari S, Hossain D, Das MK, Baqui AH, El Arifeen S, Winch PJ - Hum Resour Health (2010)

Bottom Line: High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale.The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW.Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA. pwinch@jhsph.edu.

ABSTRACT

Background: Well-trained and highly motivated community health workers (CHWs) are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh.

Methods: Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation), and informal discussion with key project personnel.

Results: Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay.

Conclusions: The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.

No MeSH data available.


Related in: MedlinePlus

Framework for decision-making process in retention and attrition of CHWs.
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Figure 1: Framework for decision-making process in retention and attrition of CHWs.

Mentions: Factors affecting retention and attrition overlap, but are not necessarily opposites. Decisions for retention or resignation are based on a complex set of trade-offs between different factors affecting different individuals differently. We need to understand how these factors interact and how the process is triggered. In this paper, we have proposed a general framework for the individual decision making process with regard to retention and attrition (see Figure 1).


Factors affecting recruitment and retention of community health workers in a newborn care intervention in Bangladesh.

Rahman SM, Ali NA, Jennings L, Seraji MH, Mannan I, Shah R, Al-Mahmud AB, Bari S, Hossain D, Das MK, Baqui AH, El Arifeen S, Winch PJ - Hum Resour Health (2010)

Framework for decision-making process in retention and attrition of CHWs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875202&req=5

Figure 1: Framework for decision-making process in retention and attrition of CHWs.
Mentions: Factors affecting retention and attrition overlap, but are not necessarily opposites. Decisions for retention or resignation are based on a complex set of trade-offs between different factors affecting different individuals differently. We need to understand how these factors interact and how the process is triggered. In this paper, we have proposed a general framework for the individual decision making process with regard to retention and attrition (see Figure 1).

Bottom Line: High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale.The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW.Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA. pwinch@jhsph.edu.

ABSTRACT

Background: Well-trained and highly motivated community health workers (CHWs) are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh.

Methods: Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation), and informal discussion with key project personnel.

Results: Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay.

Conclusions: The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.

No MeSH data available.


Related in: MedlinePlus