Community Health Workers as Street-level Quasi-Bureaucrats in the COVID-19 Pandemic: The Cases of Kenya and Thailand

Sudhipongpracha, Tatchalerm; Poocharoen, Ora-orn

doi:10.1080/13876988.2021.1879599

Cited by 8 publications

(22 citation statements)

References 42 publications

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“…This resulted in good compliance with government measures passed on from VHVs to other community members. In this respect, the VHVs play a role as street bureaucrats [12][13][14] in helping the government, medical personnel, and community members; this is an essential factor in mitigating the COVID-19 pandemic at the local level.…”

Section: Discussionmentioning

confidence: 99%

Women on the frontline of Covid-19: understanding local women village health volunteers in the northern province of Thailand

Sukhampha

Khwanriang

Vaisamruat

2023

BMC Health Serv Res

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Background This paper investigates the role of local women village health volunteers, women on the frontline, during COVID-19 in the northern province of Thailand. Methods This research employs a qualitative method with grounded-based analysis of primary data from in-depth interviews of 40 local women village health volunteers that were selected by a purposeful sampling of 10 key informants per district, live in 4 sub-districts in Chiang Mai, the northern province of Thailand: Suthep Subdistrict, Mae Hia Subdistrict, Fa Ham Subdistrict, and Tha Sala Subdistrict. Results The role of local women village health volunteers during COVID-19 is diverse, such as community health caregivers, the Surveillance and Rapid Response Team (SRRT), health facilitators and mediators, and the manager of community health funds and resources mobilization. Volunteering for local women in community health services at the local level, participating based on personal desire and foreseeable opportunities, could create meaningful participation for the local women in terms of empowering them and as a driver of local community (health) development. Conclusions Findings reveal that understanding local women’s perspectives on their roles could be made through the lens of the intersection of femininity, social role, motivation, and their contribution to their community.

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Section: Discussionmentioning

confidence: 99%

Women on the frontline of Covid-19: understanding local women village health volunteers in the northern province of Thailand

Sukhampha

Khwanriang

Vaisamruat

2023

BMC Health Serv Res

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“…Many stakeholders were recognized to have a significant influence on the urban poor community, and they participated in community service for the urban poor during the pandemic out of personal interest. City authorities – the staff of urban local bodies, which includes both elected members (public representatives) and government administrative staffs [ 13–30 ], community health workers [ 16 , 21 , 24 , 31–33 ], public health functionaries [ 14 , 19 , 20 , 30 , 33 ],, police [ 14 , 15 , 33 ], research and academic institutions [ 15 , 16 , 23 , 26 , 30 ], non-governmental organizations [ 15 , 17 , 20 , 23 , 28 , 30 , 32–34 ], media [ 28 , 33 , 35 ], and United Nations special agencies [ 18 ], as well as a few private hospitals [ 16 , 24 ] were among these stakeholders. ‘We were given rice (60 kg), lentil (1 kilogram), salt, flour (2 kg), edible oil (1 L), sugar (1 kg), pulses, and potatoes by local government officials (2 kg).…”

Section: Stakeholder Identification and Accountability Mappingmentioning

confidence: 99%

“…They also advised slum dwellers to avoid congested routes or places [ 14 , 21 ]. Community health professionals began raising community awareness in Thailand and Kenya, but the primary challenges were convincing people to collaborate and probable violence from some community members [ 32 ].…”

Section: Support Domains and Community Engagement Approachesmentioning

confidence: 99%

Community engagement and involvement in managing the COVID-19 pandemic among urban poor in low-and middle-income countries: a systematic scoping review and stakeholders mapping

Sahoo

Sahay

Dubey

et al. 2022

Global Health Action

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Background Community engagement and involvement (CEI) was crucial for the COVID-19 pandemic response, particularly among the urban poor in low-and middle-income countries (LMICs). However, no evidence synthesis explores how CEI can benefit public health emergencies. Objective We conducted a systematic scoping review of the CEI with an emphasis on stakeholder identification, accountability mapping, the support system, and the engagement process among urban poor populations in LMICs during the COVID-19 pandemic. Methods We searched eleven databases, including PubMed, Embase, Web of Science, and CINAHL, following the PRISMA-2020 guidelines to find articles published between November 2019 and August 2021. PROSPERO registration No: CRD42021283599. We performed the quality assessment using a mixed-method appraisal tool. We synthesized the findings using thematic framework analysis. Results We identified 6490 records. After the title and abstract screening, 133 studies were selected for full-text review, and finally, we included 30 articles. Many stakeholders were involved in COVID-19 support, particularly for health care, livelihoods, and WASH infrastructure, and their accountability mapping by adopting an interest – influence matrix. This review emphasizes the significance of meaningful CEI in designing and implementing public health efforts for pandemic management among urban slum populations. The interest – influence matrix findings revealed that specific community volunteers, community-based organizations, and civil society organizations had high interest but less influence, indicating that it is necessary to recognize and engage them. Conclusion Motivation is crucial for those with high influence but less interest, such as corporate responsibility/conscience and private food supply agencies, for the health system’s preparedness plan among urban populations.

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“…They are the backbones of the public healthcare systems around the world (Myomin and Lim, 2022). In developing countries, such as Thailand, community health volunteers or village health volunteers serve a critical role in extending routine primary healthcare services to the vulnerable and rural populations in Thailand for decades (Sudhipongpracha and Poocharoen, 2021). Defined as citizens who work for pay or as volunteers in collaboration with the medically trained healthcare personnel, these village health volunteers straddle dual identities.…”

Section: Introductionmentioning

confidence: 99%

Street-level quasi-bureaucracy and professional discretion: how transformational leadership and public service motivation influence village health volunteers' professional discretion

Wongpreedee,

Sudhipongpracha

2024

IJSSP

Self Cite

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PurposeVillage health volunteers are community health volunteers in Thailand that have helped the government deliver public health services for many years, particularly during the coronavirus disease 2019 (COVID-19) pandemic. Though labeled as “volunteers,” the village health volunteers are recruited, trained and supervised in a manner similar to how a government agency recruits, trains and supervises its street-level bureaucrats (SLBs). This study examines the two factors that affect how these street-level quasi-bureaucrats use their professional discretion: transformational leadership and public service motivation (PSM). Transformational leadership means a leadership style that develops, shares and sustains a vision to elevate SLBs to higher levels of performance, while PSM is defined as an SLB’s predisposition to make a difference by working in the public sector with a sense of calling. This study attempts to analyze the mediating role of psychological empowerment in the relationship between transformational leadership, PSM and professional discretion.Design/methodology/approachThe paper uses a three-wave survey-based quantitative method to avoid common method biases. This method provides evidence gathered from 105 subdistrict health promotion hospitals and 798 village health volunteers (VHVs) in five provinces in Thailand.FindingsPSM and transformational leadership influence the village health volunteers' use of professional discretion indirectly through the psychological empowerment mechanisms that make them feel positive toward their village health volunteer role and responsibility. The authors' findings suggest that the hospital directors' transformational leadership induces the village health volunteers' use of professional discretion by making them feel competent to do their work and feel fulfilled and valuable about their work. Similarly, the village health volunteers' PSM leads them to use professional discretion by making them feel fulfilled and valuable and by convincing them of the social and community impact of their work.Research limitations/implicationsWhile existing research focuses on VHVs' role in alleviating capacity constraints on the health care system, this study revealed an equally important role played by hospital directors. These directors' transformational leadership was instrumental in enhancing VHVs' psychological empowerment – particularly their perceptions of the meaning of their work and their competence – that ultimately enabled them to use professional discretion in their work. This study also highlighted the importance of VHVs' PSM, which leads to their use of professional discretion via the meaning and impact dimensions of psychological empowerment. Based on this study, PSM should also be incorporated into the community health volunteers' recruitment criteria. Also, public health agencies should consider including transformational leadership in the hospital directors' training programs and their promotion criteria.Practical implicationsAs VHVs' high-PSM level was found to enhance their professional discretion, the process of recruiting ordinary citizens to serve as community health volunteers should incorporate assessment of the candidates' PSM. Also, the Ministry of Public Health should design and assign tasks that citizen volunteers, particularly VHVs, consider meaningful and at which they feel competent.Social implicationsAside from technical training, directors of the subdistrict health promotion hospitals should regularly receive soft skill training (i.e. leadership training) and transformational leadership characteristics should be included in the government criteria for promotion.Originality/valueWhile past research has examined the impact of other leadership styles on psychological empowerment, this study took a further step by examining the mediating effects of psychological empowerment on the relationship between transformational leadership and professional discretion among VHVs. The authors analyzed the mechanism linking PSM to the VHVs' professional discretion. In addition, by examining the relative importance of different dimensions of psychological empowerment, this study offers a nuanced understanding of the psychological processes by which transformational leadership and PSM shape the SLBs' use of professional discretion in their work.

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Community Health Workers as Street-level Quasi-Bureaucrats in the COVID-19 Pandemic: The Cases of Kenya and Thailand

Cited by 8 publications

References 42 publications

Women on the frontline of Covid-19: understanding local women village health volunteers in the northern province of Thailand

Women on the frontline of Covid-19: understanding local women village health volunteers in the northern province of Thailand

Community engagement and involvement in managing the COVID-19 pandemic among urban poor in low-and middle-income countries: a systematic scoping review and stakeholders mapping

Street-level quasi-bureaucracy and professional discretion: how transformational leadership and public service motivation influence village health volunteers' professional discretion

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