BackgroundMotivation is critical to health worker performance and work quality. In Bihar, India, frontline health workers provide essential health services for the state’s poorest citizens. Yet, there is a shortfall of motivated and skilled providers and a lack of coordination between two cadres of frontline health workers and their supervisors. CARE India developed an approach aimed at improving health workers’ performance by shifting work culture and strengthening teamwork and motivation. The intervention—“Team-Based Goals and Incentives”—supported health workers to work as teams towards collective goals and rewarded success with public recognition and non-financial incentives.MethodsThirty months after initiating the intervention, 885 health workers and 98 supervisors completed an interviewer-administered questionnaire in 38 intervention and 38 control health sub-centers in one district. The questionnaire included measures of social cohesion, teamwork attitudes, self-efficacy, job satisfaction, teamwork behaviors, equitable service delivery, taking initiative, and supervisory support. We conducted bivariate analyses to examine the impact of the intervention on these psychosocial and behavioral outcomes.ResultsResults show statistically significant differences across several measures between intervention and control frontline health workers, including improved teamwork (mean = 8.8 vs. 7.3), empowerment (8.5 vs. 7.4), job satisfaction (7.1 vs. 5.99) and equitable service delivery (6.7 vs. 4.99). While fewer significant differences were found for supervisors, they reported improved teamwork (8.4 vs. 5.3), and frontline health workers reported improved fulfillment of supervisory duties by their supervisors (8.9 vs. 7.6). Both frontline health workers and supervisors found public recognition and enhanced teamwork more motivating than the non-financial incentives.ConclusionsThe Team-Based Goals and Incentives model reinforces intrinsic motivation and supports improvements in the teamwork, motivation, and performance of health workers. It offers an approach to practitioners and governments for improving the work environment in a resource-constrained setting and where there are multiple cadres of health workers.

This paper presents the application of model-based and data-driven approaches for prognostics of failures in embedded planar capacitors. An embedded planar capacitor is a thin laminate that serves both as a power/ground plane and as a parallel plate capacitor in a multilayered printed wiring board. These capacitors have gained importance with an increase in the operating frequency and a decrease in the supply voltage in electronic circuits since they can enable miniaturization of electronic circuits as well as improved electrical performance. In next generation electronic circuits, embedded planar capacitors will be crucial in communication, automotive, military, medical, and space applications. The capacitor laminate used in this study consisted of an epoxy-barium titanate nanocomposite dielectric sandwiched between Cu layers. Three electrical parameters, capacitance, dissipation factor, and insulation resistance, were monitored in situ during testing under elevated temperature and voltage-aging conditions. The failure modes observed were a sharp drop in insulation resistance and a gradual decrease in capacitance. An approach to model the time-to-failure associated with these failure modes is presented in this paper. Further, a data-driven technique known as the Mahalanobis distance method is also investigated for early detection of these failures.

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