Retention of female volunteer community health workers in Dhaka urban slums: a case-control study
This article was published in The Journal of Health Policy and Planning [©2012 Published by Oxford Journal] and the definite version is available at: http://doi.org/10.1093/heapol/czr059 The Article's website is at: http://heapol.oxfordjournals.org/content/27/6/477
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10361-66912016-11-23T10:47:50Z Retention of female volunteer community health workers in Dhaka urban slums: a case-control study Alam, Khurshid Tasneem, Sakiba Oliveras, Elizabeth BRAC Institute of Governance and Development Financial incentives Non-financial incentives Retention Urban slum Volunteer community health workers This article was published in The Journal of Health Policy and Planning [©2012 Published by Oxford Journal] and the definite version is available at: http://doi.org/10.1093/heapol/czr059 The Article's website is at: http://heapol.oxfordjournals.org/content/27/6/477 Alam, K., Tasneem, S., & Oliveras, E. (2012). Retention of female volunteer community health workers in dhaka urban slums: A case-control study. Health Policy and Planning, 27(6), 477-486. doi:10.1093/heapol/czr059 Introduction Volunteer community health workers (CHWs) are one approach to addressing the health workforce shortage in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in using female volunteer CHWs as core workers in its successful health programmes. After 25 years of implementing the CHW model in rural areas, BRAC is now using CHWs in urban slums of Dhaka through Manoshi, a community-based maternal and child health project. However, high dropout rates among CHWs in the slums suggested a need to better understand factors associated with their retention, and consequently recommend strategies for increasing their retention.Methods This mixed-method study included a case-control design to assess factors relating to the retention of volunteer CHWs, and focus group discussions (FGDs) to explore solutions to problems. In total, 542 current and 146 dropout CHWs participated in the survey. Six FGDs were held with groups of current and groups of dropout CHWs.Results Financial incentives were the main factor linked to CHW retention. CHWs who joined with the expectation of income were almost twice as likely to remain as CHWs. This finding was reinforced by the inverse association between wealth quintile of the CHWs and retention; the poorest CHWs were significantly more likely to stay in the programme than the richest. However, social prestige, community approval and household responsibilities were important non-financial factors associated with CHW retention. Restructuring and expansion of existing financial incentives to better compensate CHWs were recommended by CHWs to improve their retention.Conclusions Factors found to be important in this study are similar to those from earlier studies in rural areas. While the data indicate that financial incentives are the most commonly discussed factor regarding CHW retention in urban slums, the results also suggest other avenues that could be strengthened to improve their retention. Published 2016-11-02T10:16:14Z 2016-11-02T10:16:14Z 2012 Article 02681080 02681080 http://hdl.handle.net/10361/6691 http://doi.org/10.1093/heapol/czr059 http://heapol.oxfordjournals.org/content/27/6/477 |
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Brac University |
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Institutional Repository |
| topic |
Financial incentives Non-financial incentives Retention Urban slum Volunteer community health workers |
| spellingShingle |
Financial incentives Non-financial incentives Retention Urban slum Volunteer community health workers Alam, Khurshid Tasneem, Sakiba Oliveras, Elizabeth Retention of female volunteer community health workers in Dhaka urban slums: a case-control study |
| description |
This article was published in The Journal of Health Policy and Planning [©2012 Published by Oxford Journal] and the definite version is available at: http://doi.org/10.1093/heapol/czr059 The Article's website is at: http://heapol.oxfordjournals.org/content/27/6/477 |
| author2 |
BRAC Institute of Governance and Development |
| author_facet |
BRAC Institute of Governance and Development Alam, Khurshid Tasneem, Sakiba Oliveras, Elizabeth |
| format |
Article |
| author |
Alam, Khurshid Tasneem, Sakiba Oliveras, Elizabeth |
| author_sort |
Alam, Khurshid |
| title |
Retention of female volunteer community health workers in Dhaka urban slums: a case-control study |
| title_short |
Retention of female volunteer community health workers in Dhaka urban slums: a case-control study |
| title_full |
Retention of female volunteer community health workers in Dhaka urban slums: a case-control study |
| title_fullStr |
Retention of female volunteer community health workers in Dhaka urban slums: a case-control study |
| title_full_unstemmed |
Retention of female volunteer community health workers in Dhaka urban slums: a case-control study |
| title_sort |
retention of female volunteer community health workers in dhaka urban slums: a case-control study |
| publishDate |
2016 |
| url |
http://hdl.handle.net/10361/6691 http://doi.org/10.1093/heapol/czr059 |
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