Timely Access to Maternal, Neonatal and Child Healthcare for rural communities in Rwanda: Job satisfaction of Community Health Workers delivering Community Based Maternal, Newborn and Child Healthcare

Abstract

Background In Rwanda, although there has been progressing in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. For the improvement of equitable access to health services for maternal, newborn and child healthcare (MNCH), community-based maternal, newborn and child healthcare (CBMNCH) depends on the use of “community health workers” (CHWs). However, the CHW program faces challenges that disrupt the quality delivery of a full package of services. Yet little is known about the satisfaction of CHWs in delivering CBMNCH. Methods This quantitative cross-sectional study involved a survey of 500 sampled CHWs delivered CBMNCH in three selected rural districts of the southern province, Rwanda. Ordinal regression was used to examine the determinants of CHWs` job satisfaction. Results Multivariate analysis shows that the determinants of job satisfaction were motivation (OR = 8.59, p < 0.001), formal training in CBMNCH (OR = 2.24, p < 0.05), individual supervision (OR = 6.19, p < 0.001), and peer support (OR = 2.66, p < 0.01), knowledge about CBMNCH (OR = 0.51, p < 0.05), access to essential materials (OR = 0.32, p < 0.05), and incentives (OR = 0.53 (p < 0.01). Conclusion The findings indicated that the managers of CHW programs and other stakeholders need to improve the working conditions of CHWs to enhance their job satisfaction, to enable the effective provision of CBMNCH.

Institutional support to community health workers using integrated management of childhood illness program in Rwanda

“…Rwanda adopted IMCI as the standard of care for children using community health workers and they have an important role to play in health promotion, disease prevention, basic curative care and referrals, monitoring of health indicators, and creating vital linkages between community and formal health systems (3) . In Rwanda, the CHWs provide basic clinical care to children under five years, prevention of diseases, and health promotion across the whole nation and are free of charge (3,5) . These are thought to be due to poor access to health services and lack of immediate care when the child gets sick; delays in seeking treatment at health centers; and shortage of health workers (3,6) .…”

“…The most prevalent diseases/conditions responsible for child morbidity and mortality under five years in Rwanda are malaria, pneumonia, diarrhea and malnutrition (4) . There is a shortage of health workers with only one physician per 16,001 inhabitants and one nurse per 1,291 inhabitants (5) . Health facilities are inaccessible with a quarter of all patients having to walk for more than one hour or five kilometers to reach the nearest health facility (4) .…”