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Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya

Background: The performance of community health workers remains an area of significant global focus. The role of community health workers in sub-Saharan Africa has evolved over time in response to changing health priorities, disease burdens, and workforce demands. Recently, Kenya revised its communi...

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Autores principales: Njororai, Fletcher, Ganu, Daniel, Nyaranga, Kogutu Caleb, Wilberforce, Cholo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582826/
https://www.ncbi.nlm.nih.gov/pubmed/34770222
http://dx.doi.org/10.3390/ijerph182111707
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author Njororai, Fletcher
Ganu, Daniel
Nyaranga, Kogutu Caleb
Wilberforce, Cholo
author_facet Njororai, Fletcher
Ganu, Daniel
Nyaranga, Kogutu Caleb
Wilberforce, Cholo
author_sort Njororai, Fletcher
collection PubMed
description Background: The performance of community health workers remains an area of significant global focus. The role of community health workers in sub-Saharan Africa has evolved over time in response to changing health priorities, disease burdens, and workforce demands. Recently, Kenya revised its community health strategy in response to challenges faced with the implementation of grassroots primary health care initiative. Implementation of community health programs is often inconsistent, and they vary widely in many attributes. The purpose of this study was to explore factors influencing performance of community health workers in Vihiga County, Western Kenya in light of the political devolution. Methods: The study was a cross-sectional study design that involved a quantitative method of data collection. A sample of 309 participants was selected through cluster and simple random sampling. A self-administered and -structured questionnaire was used to gather data, s, and those who were not able to respond individually were guided by the research assistants. Results: The community health workers were 75.2% females and 24.8% males. Performance was significantly associated with not being employed, (OR = 2.4; 95% CI, 1.4–4.4), secondary education (OR = 0.7; 95% CI, 0.5–1.1), lack of conflict resolution mechanism (OR = 2.2; p = 0.017), lack of support (OR = 1.5; p = 0.03), and community health work not seen as important (OR = 1.5; p = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; p = 0.050) and poor road network (OR = 0.361; p = 0.000). Conclusions: These findings offer a deeper understanding of the interaction between CHWs contextual situations, structural challenges, and performance. Addressing influential factors of CHWs performance in multi-task settings is important in preventing overtaxing their work capacity and to maintain quality performance as countries move towards universal health coverage. Strategies for incentivizing, attracting, and sustaining men in CHWs is important to broaden perspectives about this critical role in society.
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spelling pubmed-85828262021-11-12 Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya Njororai, Fletcher Ganu, Daniel Nyaranga, Kogutu Caleb Wilberforce, Cholo Int J Environ Res Public Health Article Background: The performance of community health workers remains an area of significant global focus. The role of community health workers in sub-Saharan Africa has evolved over time in response to changing health priorities, disease burdens, and workforce demands. Recently, Kenya revised its community health strategy in response to challenges faced with the implementation of grassroots primary health care initiative. Implementation of community health programs is often inconsistent, and they vary widely in many attributes. The purpose of this study was to explore factors influencing performance of community health workers in Vihiga County, Western Kenya in light of the political devolution. Methods: The study was a cross-sectional study design that involved a quantitative method of data collection. A sample of 309 participants was selected through cluster and simple random sampling. A self-administered and -structured questionnaire was used to gather data, s, and those who were not able to respond individually were guided by the research assistants. Results: The community health workers were 75.2% females and 24.8% males. Performance was significantly associated with not being employed, (OR = 2.4; 95% CI, 1.4–4.4), secondary education (OR = 0.7; 95% CI, 0.5–1.1), lack of conflict resolution mechanism (OR = 2.2; p = 0.017), lack of support (OR = 1.5; p = 0.03), and community health work not seen as important (OR = 1.5; p = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; p = 0.050) and poor road network (OR = 0.361; p = 0.000). Conclusions: These findings offer a deeper understanding of the interaction between CHWs contextual situations, structural challenges, and performance. Addressing influential factors of CHWs performance in multi-task settings is important in preventing overtaxing their work capacity and to maintain quality performance as countries move towards universal health coverage. Strategies for incentivizing, attracting, and sustaining men in CHWs is important to broaden perspectives about this critical role in society. MDPI 2021-11-08 /pmc/articles/PMC8582826/ /pubmed/34770222 http://dx.doi.org/10.3390/ijerph182111707 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Njororai, Fletcher
Ganu, Daniel
Nyaranga, Kogutu Caleb
Wilberforce, Cholo
Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
title Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
title_full Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
title_fullStr Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
title_full_unstemmed Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
title_short Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
title_sort role of socio-demographic and environmental determinants on performance of community health workers in western kenya
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582826/
https://www.ncbi.nlm.nih.gov/pubmed/34770222
http://dx.doi.org/10.3390/ijerph182111707
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