Motivation and associated factors of health development army in the implementation of health extension packages in Northwest Ethiopia: a cross-sectional study

Abstract

IntroductionHealth development army is a network of women volunteers organised to promote health and prevent disease through community empowerment and participation.ObjectiveTo assess the level of motivation and associated factors of the health development army in the implementation of health extension packages in Northwest Ethiopia.DesignData were from a community-based cross-sectional study.SettingThis study was conducted in Mecha district, Northwest Ethiopia. The district is located around 30 km from Bahir Dar, the capital city of Amhara National Regional State, Ethiopia.ParticipantsA total of 624 health development army members were interviewed using a structured questionnaire from 20 April 2020 to 20 May 2020.Outcome measuresMotivation was assessed using a five-item Likert scale statement ranging from 1 to 5. Data were collected using a structured questionnaire and analysed using a binary logistic regression model.ResultsThe proportion of health development army members, who had motivation in the implementation of the health extension package, was 47.8% (95% CI (43.90 to 51.80)). The odds of having motivation were higher among health development army members who lived in urban areas ((adjusted OR, AOR 2.47; 95% CI (1.21 to 5.03)), were less than 30 years ((AOR 2.42; 95% CI (1.22 to 4.78)), had more than 4 years work experience ((AOR 4.72; 95% CI (2.54 to 8.76)), had high intrinsic job satisfaction ((AOR 2.31; 95% CI (1.51 to 3.55)), had good community support ((AOR 2.46; 95% CI (1.34 to 4.51)), received supportive supervision ((AOR 1.85; 95% CI (1.24 to 2.77)) and were recognised for their efforts ((AOR 1.52; 95% CI (1.01 to 2.30)).ConclusionThe proportion of motivation among health development army members was low. To increase the motivation of health development army members in the implementation of the health extension package, measures or strategies may consider targeting members who live in rural areas, are older than 30 years, have less than 4 years of work experience, report low job satisfaction, have low community support, do not have supportive supervision and are not recognised.