Inspiring health worker motivation with supportive supervision: a survey of lady health supervisor motivating factors in rural PakistanReportar como inadecuado

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BMC Health Services Research

, 16:397

Health systems and services in low and middle income settings


BackgroundCommunity health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision.

MethodsTwenty-nine lady health supervisors enrolled in Nigraan completed open-ended structured surveys with questions exploring factors that affect their motivation. Thematic analysis was conducted using a conceptual framework categorizing motivating factors at individual, community, and health system levels.

ResultsSupportive supervision, recognition, training, logistics, and salaries are community and health system motivating factors for lady health supervisors. Lady health supervisors are motivated by both their role in providing supportive supervision to lady health workers and by the supervisory support received from their coordinators and managers. Family support, autonomy, and altruism are individual level motivating factors.

ConclusionsHealth system factors, including supportive supervision, are crucial to improving lady health supervisor motivation. As health worker motivation influences their performance, evaluating the impact of health system interventions on community health worker motivation is important to improving the effectiveness of community health worker programs.

KeywordsCommunity health worker Motivation Supportive supervision Health system Implementation research Lady health supervisor Lady health worker Pakistan AbbreviationsADCAssistant District Coordinator

CCMCommunity Case Management

CHWCommunity Health Worker

CHW-PCommunity Health Worker Program

LHSLady Health Supervisor

LHWLady Health Worker

LHW-PLady Health Worker Programme

LMICLow and Middle-Income Countries

MISManagement Information System

MNCHMaternal, Newborn, and Child Health

Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1641-x contains supplementary material, which is available to authorized users.

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Autor: Fauziah Rabbani - Leah Shipton - Wafa Aftab - Kashif Sangrasi - Shagufta Perveen - Aysha Zahidie


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