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Assessing community health workers' performance motivation: a mixed-methods approach on India's Accredited Social Health Activists (ASHA) programme.
| Content Provider | Europe PMC |
|---|---|
| Author | Gopalan, Saji Saraswathy Mohanty, Satyanarayan Das, Ashis |
| Copyright Year | 2012 |
| Abstract | ObjectiveThis study examined the performance motivation of community health workers (CHWs) and its determinants on India's Accredited Social Health Activist (ASHA) programme.DesignCross-sectional study employing mixed-methods approach involved survey and focus group discussions.SettingThe state of Orissa.Participants386 CHWs representing 10% of the total CHWs in the chosen districts and from settings selected through a multi-stage stratified sampling.Primary and secondary outcome measuresThe level of performance motivation among the CHWs, its determinants and their current status as per the perceptions of the CHWs.ResultsThe level of performance motivation was the highest for the individual and the community level factors (mean score 5.94–4.06), while the health system factors scored the least (2.70–3.279). Those ASHAs who felt having more community and system-level recognition also had higher levels of earning as CHWs (p=0.040, 95% CI 0.06 to 0.12), a sense of social responsibility (p=0.0005, 95% CI 0.12 to 0.25) and a feeling of self-efficacy (p=0.000, 95% CI 0.38 to 0.54) on their responsibilities. There was no association established between their level of dissatisfaction on the incentives (p=0.385) and the extent of motivation. The inadequate healthcare delivery status and certain working modalities reduced their motivation. Gender mainstreaming in the community health approach, especially on the demand-side and community participation were the positive externalities of the CHW programme.ConclusionsThe CHW programme could motivate and empower local lay women on community health largely. The desire to gain social recognition, a sense of social responsibility and self-efficacy motivated them to perform. The healthcare delivery system improvements might further motivate and enable them to gain the community trust. The CHW management needs amendments to ensure adequate supportive supervision, skill and knowledge enhancement and enabling working modalities. |
| Journal | BMJ Open |
| Volume Number | 2 |
| PubMed Central reference number | PMC3488714 |
| Issue Number | 5 |
| PubMed reference number | 23019208 |
| e-ISSN | 20446055 |
| DOI | 10.1136/bmjopen-2012-001557 |
| Language | English |
| Publisher | BMJ Publishing Group |
| Publisher Date | 2012-09-27 |
| Publisher Place | London |
| Access Restriction | Open |
| Rights License | This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. |
| Subject Keyword | Health Services Administration & Management |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
