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

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          Abstract

          Despite resurgence in the use of community health workers (CHWs) in the delivery of community case management of childhood illnesses, a paucity of evidence for effective strategies to address key constraints of worker motivation and retention endures. This work reports the results of semi-structured interviews with 15 international stakeholders, selected because of their experiences in CHW program implementation, to elicit their views on strategies that could increase CHW motivation and retention. Data were collected to identify potential interventions that could be tested through a randomized control trial. Suggested interventions were organized into thematic areas; cross-cutting approaches, recruitment, training, supervision, incentives, community involvement and ownership, information and data management, and mHealth. The priority interventions of stakeholders correspond to key areas of the work motivation and CHW literature. Combined, they potentially provide useful insight for programmers engaging in further enquiry into the most locally relevant, acceptable, and evidence-based interventions.

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          Using thematic analysis in psychology

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            Achieving child survival goals: potential contribution of community health workers.

            There is renewed interest in the potential contribution of community health workers to child survival. Community health workers can undertake various tasks, including case management of childhood illnesses (eg, pneumonia, malaria, and neonatal sepsis) and delivery of preventive interventions such as immunisation, promotion of healthy behaviour, and mobilisation of communities. Several trials show substantial reductions in child mortality, particularly through case management of ill children by these types of community interventions. However, community health workers are not a panacea for weak health systems and will need focussed tasks, adequate remuneration, training, supervision, and the active involvement of the communities in which they work. The introduction of large-scale programmes for community health workers requires evaluation to document the impact on child survival and cost effectiveness and to elucidate factors associated with success and sustainability.
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              Qualitative research in health care. Analysing qualitative data.

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                Author and article information

                Journal
                Am J Trop Med Hyg
                Am. J. Trop. Med. Hyg
                tpmd
                The American Journal of Tropical Medicine and Hygiene
                The American Society of Tropical Medicine and Hygiene
                0002-9637
                1476-1645
                07 November 2012
                07 November 2012
                : 87
                : 5 Suppl
                : 111-119
                Affiliations
                Centre for International Health and Development, University College London, United Kingdom; Malaria Consortium Africa, Kampala, Uganda; Karolinska Institutet, Stockholm, Sweden; London School of Hygiene and Tropical Medicine, London, United Kingdom; Malaria Consortium, London, United Kingdom
                Author notes
                *Address correspondence to Daniel L. Strachan, Centre for International Health and Development (CIHD), Third Floor, 30 Guilford Street, London, UK WC1N 1EH. E-mail: d.strachan@ 123456ucl.ac.uk
                Article
                10.4269/ajtmh.2012.12-0030
                3748511
                23136286
                50a0fc24-bf7a-4c56-acd4-72c8cdc7c6a2
                ©The American Society of Tropical Medicine and Hygiene

                This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 January 2012
                : 24 July 2012
                Categories
                Articles

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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