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Background: Sustainability of any Community health worker programme is determined by several internal and external factors and is highly context and region specific. We aimed to identify factors that influence the sustainability of a community health volunteer programme across the globe.
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@#Introduction: The increasing burden of Non-Communicable Diseases and their prevalence has led Ministry of Health (MOH) Malaysia to introduce a community empowerment program “Komuniti Sihat, Perkasa Negara” acronymed as KOSPEN in July 2013. Thirty thousand community health volunteers have been trained nationwide up to May 2015. Objective: To identify the factors associated with knowledge on KOSPEN and its implementation among community health volunteers in Kulim District. Methods: A cross-sectional study based on simple random sampling was conducted among community health volunteers Kulim District. Volunteers participated in this study were 194. Data collected using self-administered questionnaire. All data collected were analysed using IBM SPSS version 22 involving descriptive and inferential statistics with significance level set at 0.05. Results: The study found that level of knowledge on KOSPEN is associated with employment status (p=0.02) and awareness level (p<0.001) among the community health volunteers. The level of implementation is associated with age (p=0.025), education level (p=0.007) and employment status (p=0.017) of the community health volunteers. Employment status (aOR=2.133, 95% CI=1.056-4.306, p=0.035) and awareness level (aOR=6.119, 95% CI=2.701-13.867 p<0.001) were predictors of level of knowledge on KOSPEN. Level of implementation of KOSPEN by the community health volunteers could be predicted by education level (aOR=4.085, 95% CI=1.299-12.851 p=0.016). Conclusion: Generally the KOSPEN volunteers had good knowledge on KOSPEN and implementation of KOSPEN program. However, there are still misconceptions among the KOSPEN volunteers regarding their functions and role. Therefore it is important to empower the volunteers with awareness on their roles, functions and good knowledge.
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About 700,000 Accredited Social Health Activists (ASHA) have been deployed as community health volunteers throughout India over the last few years. The objective of our study was to assess adherence to selection criteria in the recruitment of ASHA workers and to assess their performance against their job descriptions in Karnataka state, India. A cross-sectional survey, using a combination of quantitative and qualitative methods, was undertaken in 2012. Three districts, 12 taluks (subdistricts), and 300 villages were selected through a sequential sampling scheme. For the quantitative survey, 300 ASHAs and 1,800 mothers were interviewed using sets of structured questionnaire. For the qualitative study, programme officers were interviewed via in-depth interviews and focus group discussions. Mean±SD age of ASHAs was 30.3±5.0 years, and about 90% (261/294) were currently married, with eight years of schooling. ASHAs were predominantly (>80%) involved in certain tasks: home-visits, antenatal counselling, delivery escort services, breastfeeding advice, and immunization advice. Performance was moderate (40-60%) for: drug provision for tuberculosis, caring of children with diarrhoea or pneumonia, and organizing village meetings for health action. Performance was low (<25%) for advice on: contraceptive-use, obstetric danger sign assessment, and neonatal care. This was self-reported by ASHAs and corroborated by mothers. In conclusion, ASHA workers were largely recruited as per preset selection criteria with regard to age, education, family status, income, and residence. The ASHA workers were found to be functional in some areas with scope for improvement in others. The role of an ASHA worker was perceived to be more of a link-worker/facilitator rather than a community health worker or a social activist.