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Using a human resource management approach to support community health workers: experiences from five African countries.

Raven J, Akweongo P, Baba A, Baine SO, Sall MG, Buzuzi S, Martineau T - Hum Resour Health (2015)

Bottom Line: CHWs had many expectations of their role in healthcare, including serving the community, enhancing skills, receiving financial benefits and their role as a CHW fitting in with their other responsibilities.Many human resource management (HRM) practices are employed, but how well they are implemented, the degree to which they meet the expectations of the CHWs and their effects on human resource (HR) outcomes vary across contexts.There is a need to work with all three groups of management actors (front-line supervisors, programme managers and community members) to ensure the use of an effective HRM approach.

View Article: PubMed Central - PubMed

Affiliation: Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK. Joanna.raven@lstmed.ac.uk.

ABSTRACT

Background: Like any other health worker, community health workers (CHWs) need to be supported to ensure that they are able to contribute effectively to health programmes. Management challenges, similar to those of managing any other health worker, relate to improving attraction, retention and performance.

Methods: Exploratory case studies of CHW programmes in the Democratic Republic of Congo, Ghana, Senegal, Uganda and Zimbabwe were conducted to provide an understanding of the practices for supporting and managing CHWs from a multi-actor perspective. Document reviews (n = 43), in-depth interviews with programme managers, supervisors and community members involved in managing CHWs (n = 31) and focus group discussions with CHWs (n = 13) were conducted across the five countries. Data were transcribed, translated and analysed using the framework approach.

Results: CHWs had many expectations of their role in healthcare, including serving the community, enhancing skills, receiving financial benefits and their role as a CHW fitting in with their other responsibilities. Many human resource management (HRM) practices are employed, but how well they are implemented, the degree to which they meet the expectations of the CHWs and their effects on human resource (HR) outcomes vary across contexts. Front-line supervisors, such as health centre nurses and senior CHWs, play a major role in the management of CHWs and are central to the implementation of HRM practices. On the other hand, community members and programme managers have little involvement with managing the CHWs.

Conclusions: This study highlighted that CHW expectations are not always met through HRM practices. This paper calls for a coordinated HRM approach to support CHWs, whereby HRM practices are designed to not only address expectations but also ensure that the CHW programme meets its goals. There is a need to work with all three groups of management actors (front-line supervisors, programme managers and community members) to ensure the use of an effective HRM approach. A larger multi-country study is needed to test an HRM approach that integrates context-appropriate strategies and coordinates relevant management actors. Ensuring that CHWs are adequately supported is vital if CHWs are to fulfil the critical role that they can play in improving the health of their communities.

No MeSH data available.


Related in: MedlinePlus

Conceptual framework of the study.
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Fig2: Conceptual framework of the study.

Mentions: The conceptual framework of the study (shown in Figure 2) illustrates the linkages between CHW expectations, HRM practices, HR outcomes and the realization of CHW expectations. The study examined the characteristics, roles and expectations of the CHWs. It was assumed that the extent to which their expectations were met through appropriate HRM practices would determine the ability of the programme to attract and retain the CHWs and help understanding related to shortages or high turnover. The HRM practices examined included the following: attraction and retention; recruitment and selection – mainly in relation to skills potential to enable contribution to performance; and performance management of CHWs once engaged. HR outcomes were explored in terms of reported numbers and characteristics of CHWs, length of stay as CHW and performance against job description. Finally, an assessment was made of whether CHW expectations – in particular, in relation to attraction and retention – appeared to have been met. Data analysis aimed to understand HRM practices to identify areas needing improvement.Figure 2


Using a human resource management approach to support community health workers: experiences from five African countries.

Raven J, Akweongo P, Baba A, Baine SO, Sall MG, Buzuzi S, Martineau T - Hum Resour Health (2015)

Conceptual framework of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4556018&req=5

Fig2: Conceptual framework of the study.
Mentions: The conceptual framework of the study (shown in Figure 2) illustrates the linkages between CHW expectations, HRM practices, HR outcomes and the realization of CHW expectations. The study examined the characteristics, roles and expectations of the CHWs. It was assumed that the extent to which their expectations were met through appropriate HRM practices would determine the ability of the programme to attract and retain the CHWs and help understanding related to shortages or high turnover. The HRM practices examined included the following: attraction and retention; recruitment and selection – mainly in relation to skills potential to enable contribution to performance; and performance management of CHWs once engaged. HR outcomes were explored in terms of reported numbers and characteristics of CHWs, length of stay as CHW and performance against job description. Finally, an assessment was made of whether CHW expectations – in particular, in relation to attraction and retention – appeared to have been met. Data analysis aimed to understand HRM practices to identify areas needing improvement.Figure 2

Bottom Line: CHWs had many expectations of their role in healthcare, including serving the community, enhancing skills, receiving financial benefits and their role as a CHW fitting in with their other responsibilities.Many human resource management (HRM) practices are employed, but how well they are implemented, the degree to which they meet the expectations of the CHWs and their effects on human resource (HR) outcomes vary across contexts.There is a need to work with all three groups of management actors (front-line supervisors, programme managers and community members) to ensure the use of an effective HRM approach.

View Article: PubMed Central - PubMed

Affiliation: Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK. Joanna.raven@lstmed.ac.uk.

ABSTRACT

Background: Like any other health worker, community health workers (CHWs) need to be supported to ensure that they are able to contribute effectively to health programmes. Management challenges, similar to those of managing any other health worker, relate to improving attraction, retention and performance.

Methods: Exploratory case studies of CHW programmes in the Democratic Republic of Congo, Ghana, Senegal, Uganda and Zimbabwe were conducted to provide an understanding of the practices for supporting and managing CHWs from a multi-actor perspective. Document reviews (n = 43), in-depth interviews with programme managers, supervisors and community members involved in managing CHWs (n = 31) and focus group discussions with CHWs (n = 13) were conducted across the five countries. Data were transcribed, translated and analysed using the framework approach.

Results: CHWs had many expectations of their role in healthcare, including serving the community, enhancing skills, receiving financial benefits and their role as a CHW fitting in with their other responsibilities. Many human resource management (HRM) practices are employed, but how well they are implemented, the degree to which they meet the expectations of the CHWs and their effects on human resource (HR) outcomes vary across contexts. Front-line supervisors, such as health centre nurses and senior CHWs, play a major role in the management of CHWs and are central to the implementation of HRM practices. On the other hand, community members and programme managers have little involvement with managing the CHWs.

Conclusions: This study highlighted that CHW expectations are not always met through HRM practices. This paper calls for a coordinated HRM approach to support CHWs, whereby HRM practices are designed to not only address expectations but also ensure that the CHW programme meets its goals. There is a need to work with all three groups of management actors (front-line supervisors, programme managers and community members) to ensure the use of an effective HRM approach. A larger multi-country study is needed to test an HRM approach that integrates context-appropriate strategies and coordinates relevant management actors. Ensuring that CHWs are adequately supported is vital if CHWs are to fulfil the critical role that they can play in improving the health of their communities.

No MeSH data available.


Related in: MedlinePlus