Limits and opportunities to community health worker empowerment: a multi-country comparative study

Limits and opportunities to community health worker empowerment: a multi-country comparative study

This article was published in Social Science and Medicine [© 2016 Elsevier Ltd.] and the definite version is available at: https://www.ncbi.nlm.nih.gov/pubmed/27459022

Bibliografische gegevens
Hoofdauteurs: Kane, Sumit, Kok, Maryse, Ormel, Hermen, Otiso, Lilian, Sidat, Mohsin, Namakhoma, Ireen, Nasir, Sudirman, Gemechu, Daniel, Rashid, Sabina Faiz, Taegtmeyer, Miriam, Theobald, Sally, Koning, Korrie de
Andere auteurs: James P Grant School of Public Health, BRAC University
Formaat: Artikel
Taal:English
Gepubliceerd in: © 2016 Elsevier Ltd 2016
Onderwerpen:
Agents of social change
Community health workers
Empowerment
Performance
Online toegang:http://hdl.handle.net/10361/7252
http://doi.org/10.1016/j.socscimed.2016.07.019
id 10361-7252
record_format dspace
spelling 10361-72522018-03-27T05:07:27Z Limits and opportunities to community health worker empowerment: a multi-country comparative study Kane, Sumit Kok, Maryse Ormel, Hermen Otiso, Lilian Sidat, Mohsin Namakhoma, Ireen Nasir, Sudirman Gemechu, Daniel Rashid, Sabina Faiz Taegtmeyer, Miriam Theobald, Sally Koning, Korrie de James P Grant School of Public Health, BRAC University Agents of social change Community health workers Empowerment Performance This article was published in Social Science and Medicine [© 2016 Elsevier Ltd.] and the definite version is available at: https://www.ncbi.nlm.nih.gov/pubmed/27459022 Background In LMICs, Community Health Workers (CHW) increasingly play health promotion related roles involving ‘Empowerment of communities’. To be able to empower the communities they serve, we argue, it is essential that CHWs themselves be, and feel, empowered. We present here a critique of how diverse national CHW programs affect CHW's empowerment experience. Methods We present an analysis of findings from a systematic review of literature on CHW programs in LMICs and 6 country case studies (Bangladesh, Ethiopia, Indonesia, Kenya, Malawi, Mozambique). Lee & Koh's analytical framework (4 dimensions of empowerment: meaningfulness, competence, self-determination and impact), is used. Results CHW programs empower CHWs by providing CHWs, access to privileged medical knowledge, linking CHWs to the formal health system, and providing them an opportunity to do meaningful and impactful work. However, these empowering influences are constantly frustrated by – the sense of lack/absence of control over one's work environment, and the feelings of being unsupported, unappreciated, and undervalued. CHWs expressed feelings of powerlessness, and frustrations about how organisational processual and relational arrangements hindered them from achieving the desired impact. Conclusions While increasingly the onus is on CHWs and CHW programs to solve the problem of health access, attention should be given to the experiences of CHWs themselves. CHW programs need to move beyond an instrumentalist approach to CHWs, and take a developmental and empowerment perspective when engaging with CHWs. CHW programs should systematically identify disempowering organisational arrangements and take steps to remedy these. Doing so will not only improve CHW performance, it will pave the way for CHWs to meet their potential as agents of social change, beyond perhaps their role as health promoters. Published 2016-12-14T11:04:26Z 2016-12-14T11:04:26Z 2016 Article Kane, S., Kok, M., Ormel, H., Otiso, L., Sidat, M., Namakhoma, I., . . . de Koning, K. (2016). Limits and opportunities to community health worker empowerment: A multi-country comparative study. Social Science and Medicine, 164, 27-34. doi:10.1016/j.socscimed.2016.07.019 02779536 http://hdl.handle.net/10361/7252 http://doi.org/10.1016/j.socscimed.2016.07.019 en https://www.ncbi.nlm.nih.gov/pubmed/27459022 © 2016 Elsevier Ltd
institution Brac University
collection Institutional Repository
language English
topic Agents of social change
Community health workers
Empowerment
Performance
spellingShingle Agents of social change
Community health workers
Empowerment
Performance
Kane, Sumit
Kok, Maryse
Ormel, Hermen
Otiso, Lilian
Sidat, Mohsin
Namakhoma, Ireen
Nasir, Sudirman
Gemechu, Daniel
Rashid, Sabina Faiz
Taegtmeyer, Miriam
Theobald, Sally
Koning, Korrie de
Limits and opportunities to community health worker empowerment: a multi-country comparative study
description This article was published in Social Science and Medicine [© 2016 Elsevier Ltd.] and the definite version is available at: https://www.ncbi.nlm.nih.gov/pubmed/27459022
author2 James P Grant School of Public Health, BRAC University
author_facet James P Grant School of Public Health, BRAC University
Kane, Sumit
Kok, Maryse
Ormel, Hermen
Otiso, Lilian
Sidat, Mohsin
Namakhoma, Ireen
Nasir, Sudirman
Gemechu, Daniel
Rashid, Sabina Faiz
Taegtmeyer, Miriam
Theobald, Sally
Koning, Korrie de
format Article
author Kane, Sumit
Kok, Maryse
Ormel, Hermen
Otiso, Lilian
Sidat, Mohsin
Namakhoma, Ireen
Nasir, Sudirman
Gemechu, Daniel
Rashid, Sabina Faiz
Taegtmeyer, Miriam
Theobald, Sally
Koning, Korrie de
author_sort Kane, Sumit
title Limits and opportunities to community health worker empowerment: a multi-country comparative study
title_short Limits and opportunities to community health worker empowerment: a multi-country comparative study
title_full Limits and opportunities to community health worker empowerment: a multi-country comparative study
title_fullStr Limits and opportunities to community health worker empowerment: a multi-country comparative study
title_full_unstemmed Limits and opportunities to community health worker empowerment: a multi-country comparative study
title_sort limits and opportunities to community health worker empowerment: a multi-country comparative study
publisher © 2016 Elsevier Ltd
publishDate 2016
url http://hdl.handle.net/10361/7252
http://doi.org/10.1016/j.socscimed.2016.07.019
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