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

<b><i>Background</i>:</b> 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 demand...

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Autores principales:	Fletcher Njororai, Daniel Ganu, Kogutu Caleb Nyaranga, Cholo Wilberforce
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	performance community health workers health care roles Africa challenges Medicine R
Acceso en línea:	https://doaj.org/article/1264b89c61d74743842bc23698982dd0
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spelling	oai:doaj.org-article:1264b89c61d74743842bc23698982dd02021-11-11T16:47:01ZRole of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya10.3390/ijerph1821117071660-46011661-7827https://doaj.org/article/1264b89c61d74743842bc23698982dd02021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11707https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601<b><i>Background</i>:</b> 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. <b><i>Methods</i>:</b> 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. <b><i>Results</i>:</b> 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; <i>p</i> = 0.017), lack of support (OR = 1.5; <i>p</i> = 0.03), and community health work not seen as important (OR = 1.5; <i>p</i> = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; <i>p</i> = 0.050) and poor road network (OR = 0.361; <i>p</i> = 0.000). <b><i>Conclusions</i>:</b> 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.Fletcher NjororaiDaniel GanuKogutu Caleb NyarangaCholo WilberforceMDPI AGarticleperformancecommunity health workershealth carerolesAfricachallengesMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11707, p 11707 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	performance community health workers health care roles Africa challenges Medicine R
spellingShingle	performance community health workers health care roles Africa challenges Medicine R Fletcher Njororai Daniel Ganu Kogutu Caleb Nyaranga Cholo Wilberforce Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya
description	<b><i>Background</i>:</b> 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. <b><i>Methods</i>:</b> 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. <b><i>Results</i>:</b> 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; <i>p</i> = 0.017), lack of support (OR = 1.5; <i>p</i> = 0.03), and community health work not seen as important (OR = 1.5; <i>p</i> = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; <i>p</i> = 0.050) and poor road network (OR = 0.361; <i>p</i> = 0.000). <b><i>Conclusions</i>:</b> 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.
format	article
author	Fletcher Njororai Daniel Ganu Kogutu Caleb Nyaranga Cholo Wilberforce
author_facet	Fletcher Njororai Daniel Ganu Kogutu Caleb Nyaranga Cholo Wilberforce
author_sort	Fletcher Njororai
title	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_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_sort	role of socio-demographic and environmental determinants on performance of community health workers in western kenya
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1264b89c61d74743842bc23698982dd0
work_keys_str_mv	AT fletchernjororai roleofsociodemographicandenvironmentaldeterminantsonperformanceofcommunityhealthworkersinwesternkenya AT danielganu roleofsociodemographicandenvironmentaldeterminantsonperformanceofcommunityhealthworkersinwesternkenya AT kogutucalebnyaranga roleofsociodemographicandenvironmentaldeterminantsonperformanceofcommunityhealthworkersinwesternkenya AT cholowilberforce roleofsociodemographicandenvironmentaldeterminantsonperformanceofcommunityhealthworkersinwesternkenya
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Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya

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