Examining The Effects Of Incentive Structures On The Work Of Community Health Volunteers In Kwale County

ABSTRACT

The Community Health Strategy (CHS) is an approach that aims to improve the health status of communities through initiation and implementation of health actions at household and community levels. CHS is a highly effective way of changing healthcare practices and careseeking behavior. However, implementation of the strategy remains patchy, mostly due to challenges of retaining community health Volunteers (CHVs). Kwale, like other Kenyan counties, continues to grapple with CHV challenges. This study sought to examine factors that CHVs consider most important in incentivizing them to do their work in Kwale County. The study used a mixed methods approach. The study population were 402 CHVs in Kwale. Random sampling was used to select 197 respondents, and a questionnaire administered to collect quantitative data, which was subsequently analyzed using SPSS (Version, 23). An interview topic guide was used to collect qualitative data, and content analysis done. The study found that socio-demographic characteristics and incentives the CHVs considered most important influenced their work. Key incentives that CHVs identified as important included wages and working conditions, performance-linked payments, career and professional development, workload management, flexible working arrangements and positive working environments, training and supervision positively affected the performance of CHVs, the community factors which influence Performance of CHV include norms traditions, beliefs and security, the community appreciated the CHVs and community factors which influence Performance included norms traditions, beliefs and security. The study recommends that the County explore sustainable financial and non-financial incentives for CHVs. These may include allowances, cost reimbursement (transport), exchange tours, badges, recommendations letters, and certificates of recognition. There is a need for production and dissemination of key health information regarding the Community health strategy and targeting high impact interventions. These should include effective communication mechanisms through radios, television.