Display options
Share it on

J Rural Med. 2015;10(1):7-19. doi: 10.2185/jrm.2890. Epub 2014 Dec 06.

Reactions of community members regarding community health workers' activities as a measure of the impact of a training program in Amazonas, Brazil.

Journal of rural medicine : JRM

Ryoko Kawasaki, Toru Sadamori, Terezinha Ferreira de Almeida, Megumi Akiyoshi, Mika Nishihara, Toshiro Yoshimura, Mayumi Ohnishi

Affiliations

  1. Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
  2. Health and Development Services, Japan.
  3. Training Advisor for Community Health Workers, Manicoré, Brazil.
  4. The Hirayama Ikuo Volunteer Center, Waseda University, Japan.

PMID: 26380586 PMCID: PMC4571745 DOI: 10.2185/jrm.2890

Abstract

OBJECTIVES: The aim of this study was to evaluate the impact of community health worker (CHW) training on recognition and satisfaction regarding the performance of CHWs among members of the community in Amazonas, Brazil, which is a resource-poor area underserved with regard to medical health-care accessibility.

METHODS: Baseline and endline surveys concerning recognition and satisfaction with respect to CHW performance among members of the community were conducted by interview using a questionnaire before and after implementation of a program to strengthen community health projects in Manicoré, Amazonas, Brazil. One of the components of the project was CHW refresher training, which focused on facilitating adequate use of health-care services and providing primary health care, including health guidance. The baseline survey was performed in February 2004 at the beginning of the project, and the endline survey was performed in February 2006 at the end of the project. There were 82 and 120 CHWs working in Manicoré at the times of the baseline and endline surveys, respectively. Statistical analysis was performed to determine the significance of changes in experience with CHW activities, expected functions of CHWs, and satisfaction regarding the performance of CHWs between the baseline and endline surveys. In addition, qualitative analysis was conducted to evaluate the acceptability, feasibility, and sustainability of CHW refresher training.

RESULTS: Overall recognition and level of satisfaction regarding CHW performance among members of the community were improved from the baseline to the endline survey, regardless of type of residential area, such as town and/or remote area. Members of the community came to not expect CHWs to "provide strong medicine" (P < 0.001) and "provide injections" (P < 0.001), and came to appreciate "go to hospital with a sick person" (P = 0.031) as a function and role of CHWs.

CONCLUSIONS: The results of the present study indicated that steady approaches to motivate and support CHWs in resource-limited settings could improve performance of CHWs and satisfaction of people in the community regarding the activities of CHWs to sustain their health.

Keywords: Amazon; community health worker; satisfaction; training

References

  1. PLoS One. 2011;6(12):e27997 - PubMed
  2. Am J Public Health. 2012 Nov;102(11):e69-76 - PubMed
  3. Pan Afr Med J. 2012;13:31 - PubMed
  4. Am J Public Health. 2013 Jan;103(1):e19-27 - PubMed
  5. Health Policy Plan. 2014 May;29(3):388-95 - PubMed
  6. Hum Resour Health. 2012 Sep 27;10:38 - PubMed
  7. J Interprof Care. 2009 Jan;23(1):4-15 - PubMed
  8. Hum Resour Health. 2009 Apr 09;7:31 - PubMed
  9. Glob Public Health. 2011;6(2):125-38 - PubMed
  10. Glob Health Action. 2013 Jan 24;6:19283 - PubMed
  11. Am J Public Health. 2013 Jul;103(7):e74-82 - PubMed
  12. Am J Public Health. 2014 Aug;104(8):1540-8 - PubMed
  13. Contraception. 2013 Nov;88(5):657-65 - PubMed
  14. BMC Health Serv Res. 2013;13 Suppl 2:S6 - PubMed
  15. J Ambul Care Manage. 2011 Oct-Dec;34(4):354-61 - PubMed
  16. Glob Health Action. 2013 Jan 24;6:19228 - PubMed
  17. Diabetes Educ. 2012 May-Jun;38(3):386-96 - PubMed
  18. Global Health. 2013 Jun 11;9:25 - PubMed
  19. BMC Health Serv Res. 2013 Feb 06;13:47 - PubMed

Publication Types