Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review

Ogutu, Michael; Muraya, Kui; Mockler, David; Darker, Catherine

doi:10.1186/s12960-021-00691-z

Cited by 10 publications

(13 citation statements)

References 49 publications

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“…; https://doi.org/10.1101/2023.03. 22.23287562 doi: medRxiv preprint to Kok and colleagues, programme design factors are features of the programme or intervention design that have a direct influence on CHVs' performance and can be directly modified and adjusted to motivate maximum CHV performance (20). They include renumeration, recruitment, supervision and workload, community and health system links, and resources and logistics (2).…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…; https://doi.org/10.1101/2023.03. 22.23287562 doi: medRxiv preprint highlighted above, a systematic review by Ogutu et al, (22) showed that specific to UIS in LMICs, some of the factors that negatively impacted on the performance of CHVs at the broader contextual level in UIS included insecurity and the demand for material or financial support by households.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…Indeed, this particular finding seems to be of greater significance in urban informal settlements (including in Kenya) compared to rural and peri-urban contexts. For example, reviews by Glenton et al, and Ogutu et al, (22,66) showed that safety among CHVs working in UIS was of great concern especially due to high poverty levels in these settings, and other social challenges including criminal activities in the local areas. In Brazil for example, CHVs lived and worked in dangerous neighbourhoods with high criminal activities such as prostitution, drug use and violence.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

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“We are their eyes and ears here on the ground, yet they do not appreciate us”- Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

Ogutu

Kamui

Abuya

et al. 2023

Preprint

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Community Health Volunteers (CHVs) play a crucial role in linking the community with the formal health system, particularly in low- and middle-income countries. Studies in Kenya have focused on the implementation of the Kenya Community Health Strategy (CHS) in rural, nomadic, and peri-urban areas; with limited information on the factors that influence CHV performance in urban informal settlements. This study therefore explored factors that influence CHV performance in urban informal settlements within Nairobi Kenya and ways in which CHVs can be supported to enhance their wellbeing and strengthen community strategies. The study was undertaken in two urban informal settlements within Nairobi County. Thirteen focus group discussions (total of 123 participants) and three key informant interviews were conducted with a range of respondents. Various topics covering the design of the Community Health Strategy (CHS) and broader contextual factors that affect CHVs’ performance, were discussed and the data analysed using a framework analysis approach. The key programme design factors identified as influencing the performance of CHVs working in urban informal setting included: CHV recruitment; training; the availability of supplies and resources; and the remuneration of CHVs. Health system factors that influenced CHVs performance included: nature of relationship between healthcare workers at local referral facilities and community members; the availability of services and perceived corruption at the referral facilities; and CHV referral outside of the local health facility. Whereas the broader contextual factors that affected CHV performance at the community level included: demand for material or financial support; perceived corruption in community programmes; and neighbourhood insecurity. These findings suggest that like other CHVs working in both the rural and peri-urban settings, CHVs working in urban informal settlements in Kenya face a myriad of challenges that impact on their wellbeing and work performance. Therefore, to enhance CHVs’ well-being and improve their performance, the following should be considered: adequate and timely remuneration for CHVs, appropriate holistic training, adequate supportive supervision, and ensuring a satisfactory supply of resources and supplies. Additionally, at the health facility level, healthcare workers should be trained on appropriate and respectful relations with both the community and the CHVs, clarity of roles and scope of work, ensure availability of services, and safeguard against corrupt practices in public health facilities. Lastly, there is a need for improved and adequate security measures at the community level, to ensure safety of CHVs as they undertake their roles.

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Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

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“We are their eyes and ears here on the ground, yet they do not appreciate us”- Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

Ogutu

Kamui

Abuya

et al. 2023

Preprint

Self Cite

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“…In this study, we investigated the emergency response and healthy community construction of informal settlements, focussing not only on the importance of the local government, 25 the involvement of community volunteers 38 and the underlying wisdom of the dwellers, 11 but also on the epidemic response and interaction process of informal settlements, which have received less attention in previous research. In particular, we aimed to investigate the following: (1) How are the different participants in informal settlements, such as the local government, community committees and tenants, affected by COVID-19?…”

Section: Introductionmentioning

confidence: 99%

Vulnerable or resilient? The response of informal settlements to COVID-19: The case of urban village communities in Beijing

Dong

Wang

Lin

et al. 2022

Indoor and Built Environment

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The COVID-19 pandemic has brought topics of the impact, response and adaptation of cities in emergencies to the forefront. When compared with formal settlements, the problems faced by informal settlements are more prominent. We propose the framework of an actor-network theory, substantiated by an empirical study of three typical informal settlements in Haidian District, Beijing, in which the process, characteristics and internal mechanism of the spatial reconstruction of the informal settlements in response to COVID-19 are closely scrutinised. Human actors such as local governments, community volunteers, landlords, tenants and non-human actors all participated in the response to COVID-19 according to their goal vision and political logic, with the local government as the core driving force, forming an integrated actor network. Rooted in the special locality of informal settlements, the actor network was both hierarchical and flexible, and its inherent dynamism has proven to be efficient during COVID-19, resulting in social adaptation and spatial reconstruction. This study contributes to the cautiously optimistic estimate of similar urban community resilience in terms of global epidemics and enriches the understanding of their interlacing dynamics from the perspective of spatial reconstruction.

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“…Governance, leadership and management processes are critical: studies have looked specifically at the role of supportive supervision [12,13], performance management, evaluation and feedback [14] concern for workers' welfare by hospital management [15], as well as resource availability [14]. While a number of studies have focused on the importance of social identity, respect, and community support for community health workers [16][17][18], the study of social and professional identity and respect among front-line workers in low-and middle-income hospital settings is limited [19].…”

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confidence: 99%

‘You say you are a TB doctor, but actually, you do not have any power’: health worker (de)motivation in the context of integrated, hospital-based tuberculosis care in eastern China

2022

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Background In China, tuberculosis (TB) care, traditionally provided through the Centre for Disease Control (CDC), has been integrated into ‘designated’ public hospitals at County level, with hospital staff taking on delivery of TB services supported by CDC staff. Little is known about the impact of this initiative on the hospital-based health workers who were delegated to manage TB. Drawing on a case study of two TB ‘designated’ hospitals in Zhejiang province, we explored factors influencing hospital-based health workers’ motivation in the context of integrated TB service delivery. Methods We conducted 47 in-depth interviews with health officials, TB/hospital managers, clinicians, radiologists, laboratory staff and nurses involved in the integrated model of hospital-based TB care. Thematic analysis was used to develop and refine themes, code the data and assist in interpretation. Results Health workers tasked with TB care in ‘designated’ hospitals perceived their professional status to be low, related to their assessment of TB treatment as lacking need for professional skills, their limited opportunities for professional development, and the social stigma surrounding TB. In both sites, the integrated TB clinics were under-staffed: health workers providing TB care reported heavy workloads, and expressed dissatisfaction with a perceived gap in their salaries compared with other clinical staff. In both sites, health workers were concerned about poor infection control and weak risk management assessment systems. Conclusions Inadequate attention to workforce issues for TB control in China, specifically the professional status, welfare, and development as well as incentivization of infectious disease control workers has contributed to dissatisfaction and consequently poor motivation to serve TB patients within the integrated model of TB care. It is important to address the failure to motivate health workers and maximize public good-oriented TB service provision through improved government funding and attention to the professional welfare of health workers providing TB care in hospitals.

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Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review

Cited by 10 publications

References 49 publications

“We are their eyes and ears here on the ground, yet they do not appreciate us”- Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

“We are their eyes and ears here on the ground, yet they do not appreciate us”- Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

Vulnerable or resilient? The response of informal settlements to COVID-19: The case of urban village communities in Beijing

‘You say you are a TB doctor, but actually, you do not have any power’: health worker (de)motivation in the context of integrated, hospital-based tuberculosis care in eastern China

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