Retaining CHWs is essential in the sustainability of CHW programs; yet, there is little literature on reasons for their attrition that might help CHW retention. This study measured CHW attrition and its predictors in a rural area in Kenya.
China has a history of integrating CHWs in public health intervention programs. Known as village doctors, these CHWs provide treatment and public responsibilities health. This systematic review identifies the public health services provided by CHWs and describes the potential barriers and facilitators of these services.
This study examines the effects of community health workers on participation in the Heart Smarts program implemented by the Food Trust. Results show higher participant retention rates and lower blood pressure rates in stores that had community health workers. The authors suggest that having community health workers in other sites would increase the number of repeat visits and help in lowering participant blood pressure.
This review covers studies published since 2005 that involve attrition rates of health workers. Understanding attrition from the health workforce is critical to workforce planning, especially since many places have shortages of health workers.
This resource from USAID and MCHIP provides an overview of large-scale CHW programs from 13 countries: Afghanistan, Bangladesh, Brazil, Ethiopia, India, Indonesia, Iran, Nepal, Niger, Pakistan, Rwanda, Zambia and Zimbabwe. Case studies address the historical context of CHWs, the health needs of the country, the scope of work of the CHWs, CHW training, support and supervision, and financing of CHW programs. The demonstrated impact and continuing challenges of the different programs are also addressed.
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.
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.