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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

Individual and contextual factors associated with community health workers’ performance in Nyanza Province, Kenya: a multilevel analysis

Authors: Yoshito Kawakatsu, Tomohiko Sugishita, Junya Tsutsui, Kennedy Oruenjo, Stephen Wakhule, Kennedy Kibosia, Eric Were, Sumihisa Honda

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Several African and South Asian countries are currently investing in new cadres of community health workers (CHWs) as a major part of strategies aimed at reaching the Millennium Development Goals. However, one review concluded that community health workers did not consistently provide services likely to have substantial effects on health and that quality was usually poor. The objective of this research was to assess the CHWs’ performance in Western Kenya and describe determinants of that performance using a multilevel analysis of the two levels, individual and supervisor/community.

Methods

This study conducted three surveys between August and September 2011 in Nyanza Province, Kenya. The participants of the three surveys were all 1,788 active CHWs, all their supervisors, and 2,560 randomly selected mothers who had children aged 12 to 23 months. CHW performance was generated by three indicators: reporting rate, health knowledge and household coverage. Multilevel analysis was performed to describe the determinants of that performance.

Results

The significant factors associated with the CHWs’ performance were their marital status, educational level, the size of their household, their work experience, personal sanitation practice, number of supervisions received and the interaction between their supervisors’ better health knowledge and the number of supervisions.

Conclusion

A high quality of routine supervisions is one of the key interventions in sustaining a CHW’s performance. In addition, decreasing the dropout rate of CHWs is important both for sustaining their performance and for avoiding the additional cost of replacing them. As for the selection criteria of new CHWs, good educational status, availability of supporters for household chores and good sanitation practices are all important in selecting CHWs who can maintain their high performance level.
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Metadata
Title
Individual and contextual factors associated with community health workers’ performance in Nyanza Province, Kenya: a multilevel analysis
Authors
Yoshito Kawakatsu
Tomohiko Sugishita
Junya Tsutsui
Kennedy Oruenjo
Stephen Wakhule
Kennedy Kibosia
Eric Were
Sumihisa Honda
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1117-4

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