This article provides background information on the incentive system for India’s Accredited Social Health Activists (ASHAs). India has created an outcome-based incentive system which creates a clear difference in payment per patient.
In Madagascar 83% of the country’s 22.9 million people live in rural areas that can be difficult to access. CHWs play a crucial role in providing access to healthcare in those parts of the country that are underserved. Over 34,000 CHWs work to extend basic health services such as maternal and child health, family planning and reproductive health, nutrition, TB, and sanitation services. This study seeks to examine the influence both financial and non-financial incentives have on CHW program performance and retention in Madagascar.
While task shifting to CHWs is widely practiced to address healthcare provider shortages, it can add to an already heavy workload for CHWs. In order to reflect how CHWs perceive and react to their circumstances, this study combined perception and objective measures of workload to examine quality of services, worker performance, and job and client satisfaction.
In the past 36 months, Nigeria has suffered several healthcare workers’ strikes, resulting in decreased access to quality healthcare for Nigerians. The researchers in this study aimed to identify the root cause(s) for these strikes and determine potential solutions. 150 Nigerian healthcare workers participated in a cross-sectional survey and questionnaire to reveal reasons for the strikes. Findings concluded that increased salaries and wages were among the most common reasons for strikes, though other issues were discussed as well.
The FCHV Program in Nepal was initiated in 1988/89 with the goal of supporting national health through community involvement. Currently there are 52,000 FCHVs with varying roles and responsibilities related to health. This presentation discusses the 2014 survey aimed at understanding FCHVs perceptions of their work, as well as the communities’ perceptions of FCHVs. Using a mixed methods strategy, researchers conducted a cross-sectional assessment of 13 domains in Nepal.
In light of the health worker shortage due to the post-conflict period and Ebola crisis in Sierra Leone, it is crucially important to understand different motivation factors for rural health workers, including doctors, nurses, midwives and Community Health Workers. Researchers conducted 23 participatory life histories with health workers, revealing that the context of the rural healthcare setting makes it difficult for health workers to conduct their work. These findings could be used to influence policy and help build a more robust rural healthcare workforce.
CHWs importantly deliver health care services to communities when shortages in the healthcare workforce exist. However, as their workload increases, CHW abilities to provide quality healthcare may be compromised. Using a cluster-randomized trial in Zimbabwe, CHWs were surveyed to assess the association between demographic and work characteristics and task performance. CHWs who made more referrals shared many common demographic and work characteristics, implying that these factors influence performance.
To work well, health supply chains require timeliness, accuracy, and reliability at all stages. Even one break in the supply chain—an hours’ delay in delivery—”can have repercussions throughout the system, ultimately determining if families can access life-saving medicines and commodities.” Thus it is crucial that all actors—from procurement specialists to storekeepers and service providers—do their part to keep the system running.