Factors associated with child health service delivery by female community health volunteers in Nepal: findings from a national survey

Abstract

Background: Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been many studies on child health in Nepal however, rarely explored the status and factors associated with the child health service provided by these volunteers. This study aimed to identify the factors associated with the child health service delivery by FCHVs. Methods: A national survey was conducted in 2014 in Nepal that included 4302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. Factors associated with the use of child health services was examined using Chi-square test (χ 2) followed by logistic regression. Results: Overall, 62.6% of FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted health mothers' group meeting, involved in local committees and those who supported antenatal care and outreach clinics related activities had higher odds of providing child health services. Similarly, FCHVs equipped with the stock of Cotrimoxazole tablet, Zinc tablet, Oral Rehydration Salt packets were more likely to provide child health services. The province-wise analysis showed that FCHVs from Province 5 and Sudur Paschim Province were more likely to provide child health services compared to their counterparts from province 1. Technologywise, FCHVs who were using mobile were more likely to provide child health services. Conclusions: FCHVs are important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs; availability of key commodities, involvement of FCHVs in regular health mothers' group meeting, use of mobile phone, involvement in other public health programs and social networks, and utilization of the FCHV fund need to be taken into consideration.

Role of Community Health Volunteers Since the 2015 Nepal Earthquakes: A Qualitative Study

“…35 The national FCHV survey also identified the availability of key commodities is crucial. 36 Reduced access to medical equipment during emergencies could prevent a timely response. To increase access to medical equipment in future emergencies, it is important to integrate their roles and functions into the national health systems and to recognize CHWs as a key Health EDRM workforce groups.…”

Using mobile health to strengthen the communication skills for effective delivery of health information in Nepal: A qualitative study of the perspectives of Female Community Health Volunteers

“…4 The role of FCHVs has also been crucial to reducing child mortality by twothirds in 2015 compared to 1990 in Nepal. 5 Despite all these achievements, FCHVs are volunteers with no minimum educational requirements, limited training opportunities, infrequent and inconsistent supervision, receive intermittent and inconsistent incentives, and have no career advancement opportunities. 6 FCHVs are overburdened due to programmatic defragmentation and are obliged to perform multiple tasks for similar activities.…”