Interventions to Improve Motivation and Retention of Community Health Workers Delivering Integrated Community Case Management (iCCM): Stakeholder Perceptions and Priorities

Strachan, Daniel; Källander, Karin; Asbroek, A. H. A. ten; Kirkwood, Betty; Meek, Sylvia; Benton, Lorna; Conteh, Lesong; Tibenderana, James; Hill, Zelee

doi:10.4269/ajtmh.2012.12-0030

Cited by 127 publications

(162 citation statements)

References 18 publications

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“…A study in Uganda noted that if the community health workers did not receive prompt responses from the end-user, or if they had an issue that was never resolved, they would become demoralized [37]. mHealth can also affect the ways front-line users feel about their jobs, with one group of community health workers reporting that the use of mobile technology for data collection distanced them from the human aspect of their job, and turned them into ‘data collection robots’ [38]. …”

Section: User Considerationsmentioning

confidence: 99%

Integrating mHealth at point of care in low- and middle-income settings: the system perspective

Wallis

Blessing

Dalwai

et al. 2017

Global Health Action

122

121

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While the field represents a wide spectrum of products and services, many aspects of mHealth have great promise within resource-poor settings: there is an extensive range of cheap, widely available tools which can be used at the point of care delivery. However, there are a number of conditions which need to be met if such solutions are to be adequately integrated into existing health systems; we consider these from regulatory, technological and user perspectives. We explore the need for an appropriate legislative and regulatory framework, to avoid ‘work around’ solutions, which threaten patient confidentiality (such as the extensive use of instant messaging services to deliver sensitive clinical information and seek diagnostic and management advice). In addition, we will look at other confidentiality issues such as the need for applications to remove identifiable information (such as photos) from users’ devices. Integration is dependent upon multiple technological factors, and we illustrate these using examples such as products made available specifically for adoption in low- and middle-income countries. Issues such as usability of the application, signal loss, data volume utilization, need to enter passwords, and the availability of automated or in-app context-relevant clinical advice will be discussed. From a user perspective, there are three groups to consider: experts, front-line clinicians, and patients. Each will accept, to different degrees, the use of technology in care – often with cultural or regional variation – and this is central to integration and uptake. For clinicians, ease of integration into daily work flow is critical, as are familiarity and acceptability of other technology in the workplace. Front-line staff tend to work in areas with more challenges around cell phone signal coverage and data availability than ‘back-end’ experts, and the effect of this is discussed.

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Section: User Considerationsmentioning

confidence: 99%

Integrating mHealth at point of care in low- and middle-income settings: the system perspective

Wallis

Blessing

Dalwai

et al. 2017

Global Health Action

122

121

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“…Traditionally, there are differences in the activities performed by, and duties expected of, paid and volunteer CHWs [16]. It has been suggested that policymakers may be concerned that financial incentives which are perceived as too low, are paid irregularly, or are terminated due to fluctuations in funding may be more of a disincentive to CHWs than no payment at all [17,18]. There is, however, evidence from Haiti and Brazil that irregularities in payment need not be detrimental providing sufficient institutional effort is put into managing available funding and staff motivation [14,19].…”

Section: Introductionmentioning

confidence: 99%

Paid staff or volunteers – does it make a difference? The impact of staffing on child outcomes for children attending community-based programmes in South Africa and Malawi

Tomlinson

Sherr

Macedo

et al. 2017

Global Health Action

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Background: Globally, and in low and middle income countries (LMIC) specifically, there is a critical shortage of workers. The use of volunteers to support such care delivery systems has been examined, there is scant literature on the impact of volunteers on child outcome in high human immunodeficiency virus (HIV)-affected communities. Objectives: To examine the differential impact of paid versus volunteer workforce in Community Based Organisations (CBOs) providing care to children and families affected by the HIV epidemic in South Africa and Malawi on child outcomes over time. Methods: This study compared child outcomes for 989 consecutive children attending CBOs (0.7% refusal) at baseline and 854 at follow-up (86.3% response rate). Results: Children attending CBOs with paid staff had higher self-esteem, fewer emotional/behavioural problems and less perceived stigma. Likewise, children attending CBOs with paid staff had fewer educational risks, and 20 heightened cognitive performance, and the digit-span memory test. After controlling for outcome at baseline, gender, age, HIV status, and disability, attending a CBO with paid staff remained a significant independent predictor of higher self-esteem scores, less perceived stigma, as well as fewer educational risks and better performance on the drawing test. We found no associations between CBO attendance – paid or volunteer – and children’s depressive and trauma symptoms. Conclusions: Our findings show that in order to most optimally impact on child outcome 30 community-based workers (CBWs) should ideally be paid with trained staff. Specialised input for more severe child difficulties is needed.

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“…La salud móvil (mHealth) es un área de salud electrónica (eHealth) que provee: a) servicios sanitarios e información utilizando las tecnologías móviles, y b) servicios de diseminación de la información respecto a actualizaciones sanitarias, materiales didácticos, y recordatorios. El mHealth está abriendo un mundo de oportunidades en el ámbito de la salud pública, en particular en los países con recursos limitados como Paraguay (Mechael, 2009;UNDP, 2012b;Strachan, Källander, Ten Asbroek, Kirkwood, Meek, Benton & Hill, 2012).…”

Section: Introductionunclassified

mhealth Model for Simplified epidemiological surveillance in Paraguay

et al. 2017

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RESUMENObjetivo. Describir el desarrollo e implementación de un sistema de vigilancia epidemiológica simplificada basado en un modelo mhealth diseñado para el Chaco Paraguayo. Material y método. El sistema consiste en una central telefónica por software, aplicaciones de tipo WEB y base de datos, todos ellos de código libre. La cantidad de casos objeto de la vigilancia se reportan al sistema mediante la pulsación de teclas en el teléfono respondiendo a las preguntas del contestador automático. Resultados. El modelo se implementó en cinco localidades del Distrito "Teniente Irala Fernández" del Chaco Paraguayo; los síndromes seleccionados fueron: diarreico, febril agudo, respiratorio agudo, respiratorio crónico y febril eruptivo. El sistema permite la notificación semanal (un día fijo de la semana) en el que se envía mensajes recordatorios cada hora hasta que la notificación sea efectiva. Asimismo se permite la notificación de alerta (en cualquier momento). El sistema realiza la confirmación de las notificaciones a todos los niveles de usuarios. Entre el 15 de mayo al 20 de noviembre de 2013, fueron notificados al sistema 968 casos: 171 diarreas, 770 respiratorio agudo y 27 respiratorio crónico. El modelo fue reconocido como sencillo, de fácil manejo y de gran utilidad. Conclusión. Se dispone de un modelo de notificación epidemiológica comunitaria con muy buena aceptación debido a su simplicidad. El sistema ha generado información sobre las tendencias de estos síndromes en estas comunidades, coincidentes con la situación nacional.Palabras clave: vigilancia epidemiológica; notificación; telefonía móvil; Chaco Paraguayo.1 El presente manuscrito no ha sido publicado total o parcialmente por ningún otro medio o enviado a otra revista para su publicación.

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Interventions to Improve Motivation and Retention of Community Health Workers Delivering Integrated Community Case Management (iCCM): Stakeholder Perceptions and Priorities

Cited by 127 publications

References 18 publications

Integrating mHealth at point of care in low- and middle-income settings: the system perspective

Integrating mHealth at point of care in low- and middle-income settings: the system perspective

Paid staff or volunteers – does it make a difference? The impact of staffing on child outcomes for children attending community-based programmes in South Africa and Malawi

mhealth Model for Simplified epidemiological surveillance in Paraguay

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