Abstract:
Introduction: Community Health Workers (CHWs) were recognized as the cornerstone of
comprehensive during the Alma Ata conference in 1978. CHWs were defined as being able
to serve communities in the remote areas and to assist in meeting the unmet demand for
health care services across countries. The CHWs would improve access to health care
services among the poor and in the geographically medically underserved regions. Since the
implementation of CHW programs across countries there has been an experience of high
attrition rates ranging from 3.2% to 77 % which could be attributed to several factors and
low morale among the CHWs.
Methods: A community based Cross-sectional comparative design was used which
employed both qualitative and quantitative methods of data collection.
Findings: Receiving of subsequent training, frequency of supervision and number of
households served by the CHWs was significantly associated with performance. Majority of
CHWs for both groups were satisfied with their job with 40.4% of CHWs not receiving
incentives compared to 46.6% among CHWs receiving monetary incentives. Majority of
CHWs had ever contemplated dropping off their CHW roles with the major constraints faced
by CHWs cited being lack of support of the supervisors and lack of transport.
Conclusions and recommendations: The CHWs performance can be enhanced through
subsequent training, harmonization of the training curriculum, setting up of proper
supervision mechanisms, harmonization of workload, and provision of transport and
community support.
