Examining health-care volunteerism in a food- and financially-insecure world

Maes, Kenneth

doi:10.2471/blt.09.074120

Cited by 18 publications

(20 citation statements)

References 16 publications

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“…Secondly, by claiming that low-income volunteers freely consent to donate their labor based on their motivations to help others and serve the community, programs may be able to justify the use of low-income people for unpaid community health labor. Further, local low-income volunteers are often said to derive and be motivated by psychosocial benefits (i.e., social respect and “mental satisfaction”) through serving the health interests of needy people (Maes 2010a). Relying on unpaid labor might also be justified by appealing to the humanitarian goal of saving lives and improving health among needy populations through “rolling-out” pharmaceutical technologies, particularly in exceptional or crisis-level contexts such as the HIV/AIDS pandemic in sub-Saharan Africa (Biehl 2007; Fassin and Vasquez 2005).…”

Section: Introductionmentioning

confidence: 99%

Volunteerism or Labor Exploitation? Harnessing the Volunteer Spirit to Sustain AIDS Treatment Programs in Urban Ethiopia

Maes¹

2012

Human Organization

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Based on ethnographic research in Addis Ababa, Ethiopia, this paper describes NGO efforts to encourage AIDS care volunteers to eschew material returns for their labor and instead reflect on the goodness of sacrificing to promote the survival of people living with HIV/AIDS. Consensus analysis of motivational survey data collected from a sample of AIDS care volunteers (n=110) suggests that they strongly share a sacrificial and prosocial motivational model. These results may be explained by several factors, including the efforts of the organizations to shape volunteers' motivations, the self-selection of volunteers, positive reinforcement in seeing one's patients become healthy, and social desirability bias. In-depth interviews examining the motivations and behaviors of volunteers reveal a more complicated picture: even ostensibly devoted and altruistic volunteers strongly question their service commitments. The complexity and ambivalence of volunteers' motivations reflect the profound uncertainty that they face in achieving improved socioeconomic status for themselves and their families amid widespread unemployment and sharply rising food prices. Their desires for economic opportunities explain why local NGOs exert so much effort to shape and sustain-and yet fail to completely control-their motivations. This recasts economically-insecure volunteers' consent to donate their labor as a process of negotiation with their organizers. Future research should explore how models of health care volunteerism and volunteer motivations are shaped by individual and collective experiences in political-economic context.

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Section: Introductionmentioning

confidence: 99%

Volunteerism or Labor Exploitation? Harnessing the Volunteer Spirit to Sustain AIDS Treatment Programs in Urban Ethiopia

Maes¹

2012

Human Organization

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“…Our findings suggest the need for programmatic interventions that address needs for secure and gainful employment among the volunteers in our study, to reduce poverty and food insecurity and improve mental health for both HIV‐positive and HIV‐negative volunteers, while taking into account the different experiences of men and women. While much attention within policy circles is paid to non‐monetary techniques to incentivize low‐income people to take up and commit to volunteer community health work (e.g., Glenton et al 2010), our focus emphasizes the potential of anthropological inquiries to inform goals of poverty‐reduction and increased well‐being at household and community scales through health sector job creation (Maes 2010; Maes et al 2010b; Maes et al 2011). Our results suggest that job creation, and in particular creation of paid community health worker positions for people on the low end of the socioeconomic scale, will improve food access, reduce economic uncertainty, and bolster the autonomy of male and female volunteers in our sample, thereby substantially reducing the stress they experience as they attempt to meet their own needs and the needs of their care recipients.…”

Section: Discussionmentioning

confidence: 99%

Cycles of Poverty, Food Insecurity, and Psychosocial Stress Among Aids Care Volunteers in Urban Ethiopia

Maes

Shifferaw²

2011

Annals of Anthropol Pract

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With the rollout of AIDS therapies, volunteer AIDS care has been promoted across Africa under the assumption that volunteerism is economically imperative in settings of health professional and resource scarcity. As low-income volunteers have become a major part of HIV/AIDS prevention and treatment workforces, it is imperative to question how poverty impacts their well-being. This chapter presents epidemiologic data collected during the 2008 food crisis from a sample of 110 AIDS care volunteers in Addis Ababa, Ethiopia, as well as narratives offered by HIV-positive volunteers, highlighting a widely overlooked way in which food insecurity and mental distress impact efforts to treat AIDS in sub-Saharan Africa. Food insecurity and elevated common mental disorder (CMD) symptom loads were common and tightly linked among the volunteers in the sample. Volunteers who were HIV-positive (17 percent) fared slightly worse in terms of food insecurity and psychosocial well-being. However, positive HIV serostatus was not associated with CMD in multivariate analyses accounting for food insecurity. Narratives illustrate how being HIV-positive shaped experiences of psychosocial stress, which involved unemployment and lack of prospects for marital relationships or strife within them. Our focus demonstrates the potential for mixing ethnographic and epidemiological methods to inform policy questions regarding poverty-reduction through compensation for volunteers’ valuable labor, as well as AIDS care program sustainability. [volunteerism, AIDS care, food insecurity, livelihoods, HIV, psychosocial health]

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“…Firstly, though it has been argued that to strengthen CHWs, financial remuneration in a predictable fashion should be considered (Maes, 2010), it is equally recognized that other non-monetary benefits can play a big role in motivating CHWs (Brunie et al, 2014). Indeed, VHTs showed great appreciation for the symbolic rewards they received for being volunteers such as social respect and other interpersonal relationships.…”

Section: Discussionmentioning

confidence: 99%

Towards Promotion of Community rewards to Volunteer Community Health Workers? Lessons from Experiences of Village Health Teams in Luwero, Uganda

Turinawe¹,

Rwemisisi²,

Musinguzi³

et al. 2016

RHS

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Examining health-care volunteerism in a food- and financially-insecure world

Cited by 18 publications

References 16 publications

Volunteerism or Labor Exploitation? Harnessing the Volunteer Spirit to Sustain AIDS Treatment Programs in Urban Ethiopia

Volunteerism or Labor Exploitation? Harnessing the Volunteer Spirit to Sustain AIDS Treatment Programs in Urban Ethiopia

Cycles of Poverty, Food Insecurity, and Psychosocial Stress Among Aids Care Volunteers in Urban Ethiopia

Towards Promotion of Community rewards to Volunteer Community Health Workers? Lessons from Experiences of Village Health Teams in Luwero, Uganda

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