Implementation framework for Income Generating Activities identified by community heath volunteers: a strategy to reduce CHV attrition rate in Kilifi County Kenya

Author:

Riang’a Roselyter Monchari1,Nyanja Njeri2,Lusambili Adelaide3,Mwangi Eunice Muthoni1,Ehrlich Joshua R.4,Clayde Paul5,Mostert Cyprian6,Ngugi Anthony1

Affiliation:

1. Department of Population Health, Aga Khan University, Nairobi

2. Department of Family Medicine, Aga Khan University Hospital, Nairobi

3. Institute for Human Development, Aga Khan University, Nairobi

4. Institute for Social Research, University of Michigan, Ann Arbor, Michigan

5. William Davidson Institute at the University of Michigan, Ann Arbor, Michigan

6. Brain and Mind Institute, Aga Khan University, Nairobi

Abstract

Abstract Background Strategy Implementation has increasingly become a focus of scientific studies. Failure of strategy implementation may result in high monetary costs, wasted time and human resources, and reduced community enthusiasm and diminished trust in project sponsors. This study sought to investigate viable modalities for implementing Income Generating Activities (IGAs) for Community Health Volunteers (CHV) in Kilifi County Kenya as a strategy to improve their livelihoods, increase motivation and reduce attrition. Methods: This was an exploratory qualitative research study. Key informant in-depth interviews were conducted among sub-county Ministry officials and multi-lateral stakeholder representatives. A further 10 Focus group discussions with CHVs were conducted. The data were thematically analysed using MAXQDA 20.2 software. Data codding, analysis and presentation was guided by the Okumu’s (2003) Strategy Implementation framework on factors to consider when implementing strategic decisions: 1) Need for Strategy (Income Generating activities) development, 2) Operational process [ (i) IGAs selection strategy, ii) Resources, iii) people & iv) controls. A new variable, however, emerged from the findings; namely, networks. Results: A need for stable income was identified as the driving factor for CHVs seeking IGAs, as their health volunteer work is non-remunerative. Contextualized projects that acknowledged diversity of CHVs in terms of environmental conditions of origin, experience, culture, and market viability, informed their IGA selection strategy. Self-savings through table-banking, seeking funding support through loans xx from government funding agencies (e.g., Uwezo Fund, Women Enterprise fund, Youth Fund), grants from corporate agencies, politicians, and other donors were proposed. Formal registration of IGAs with a Government Ministry, developing a guiding constitution, empowering CHVs with leadership skills, project and group diversity management, and entrepreneurial skills, and connecting them to support agencies, were the control measures proposed by the CHVs & Key Informants to enhance sustainability of IGAs. Group owned and managed IGAs were preferred over individual IGAs. Conclusion: CHVs are in need of IGAs and proposed their own implementation strategies informed by local context. Agencies supporting IGAs should therefore be guided by the modalities proposed by CHVs and local stakeholders.

Publisher

Research Square Platform LLC

Reference33 articles.

1. Identifying key challenges facing healthcare systems in Africa and potential solutions;Oleribe OO;Int J Gen Med,2019

2. Department of Health Services Kilifi County. Kilifi County Government Department of Health Services Incentive Framework for Attraction and Retention of Health Workforce. 2018; 24. Available: file:///C:/Users/admin/Downloads/Kilifi County Incentives framework for attraction and retention of health workforce (1).pdf

3. Kenya National Bureau of Statistics. 2019 Kenya Population and Housing Census Volume 1: Population by County and Sub-County. 2019 Kenya Popul Hous Census. Nairobi, Kenya; 2019. Available: https://www.knbs.or.ke/?wpdmpro=2019-kenya-population-and-housing-census-volume-i-population-by-county-and-sub-county

4. Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness;Perry HB;Annu Rev Public Health,2014

5. Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: A systematic review;Gilmore B;BMC Public Health,2013

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3