Inspiring health worker motivation with supportive supervision: a survey of lady health supervisor motivating factors in rural Pakistan

Abstract

BackgroundCommunity health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision.MethodsTwenty-nine lady health supervisors enrolled in Nigraan completed open-ended structured surveys with questions exploring factors that affect their motivation. Thematic analysis was conducted using a conceptual framework categorizing motivating factors at individual, community, and health system levels.ResultsSupportive supervision, recognition, training, logistics, and salaries are community and health system motivating factors for lady health supervisors. Lady health supervisors are motivated by both their role in providing supportive supervision to lady health workers and by the supervisory support received from their coordinators and managers. Family support, autonomy, and altruism are individual level motivating factors.ConclusionsHealth system factors, including supportive supervision, are crucial to improving lady health supervisor motivation. As health worker motivation influences their performance, evaluating the impact of health system interventions on community health worker motivation is important to improving the effectiveness of community health worker programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1641-x) contains supplementary material, which is available to authorized users.

Satisfaction in Delivering Maternal and Neonatal Health Services During a Pandemic: Recommendations for Infection Preparedness and Response Protocols and Employee Support for Community Health Workers 

“…Jaskiewicz & Tulenko, 2012; Rabbani, Shipton, et al, 2016). Secondly, we found that coronavirus responsiveness has an indirect effect on maternal and neonatal health services via the mediation of employee satisfaction.…”

“They have been neglected for a long time”: a qualitative study on the role and recognition of Rural Health Motivators in the Shiselweni region, Eswatini

“…Studies have identi ed the impact of poor structural support; links between insu cient compensation and negative outcomes, including psychological distress [38] or nancial compensation as a key motivator for CHW performance [39,40]. However, monetary recognition is not consistently seen as a singular motivator for work.…”

“…However, monetary recognition is not consistently seen as a singular motivator for work. Supportive supervision has shown to address challenges of recognition and improve work output [1,5,40,41] and regular training is positively associated with CHW con dence in their role [1,42]. In order to enhance institutional recognition of the programme, and make further positive health contributions at community level, increased structural support is needed, designed in consultation with RHMs.…”

“…Globally, the lack of recognition of CHWs in MoH programmes has been cited as a challenge [19,40,[43][44][45]. Increased recognition is seen as potentially improving lay health worker performance [41].…”

One Size Does Not Fit All: The Importance of Contextually Sensitive mHealth Strategies for Frontline Female Health Workers

“…Each LHV usually supervises 20-25 LHWs. A supervisor LHV is responsible for training LHWs, and ensuring quality performance by LHWs by collecting monthly reports from the LHWs which provide information on type of cases encountered and relevant services provided (Rabbani et al, 2014(Rabbani et al, , 2016.…”