Membership in CHW's
Cooperatives
CHWs cooperatives membership: All CHWs organized are in
cooperatives to ensure income generation and accountability of expected
results. Community PBF payments used for cooperative income generating projects
include: poultry, cattle/goat/pig rearing, crop farming, basket making, etc
that improves performance of CHWs by motivating them to rise agreed upon
performance indicators, the payments made when proof of the agreed level of
performance. The Sector Steering Committee oversees the implementation and
approves payment to the CHW Cooperative (MOH, Rwanda, 2011).
The study done by Havard School (2011), on CHWs in Zambia
entetle'' incentives design and management it shows incentives and
desincentives summirized in below :
Table 1: Showing Incentives and
Desincentives CHWs
|
Motivation factors
|
Incentives
|
Disincentives
|
|
Monetary incentives that motivate CHWs
|
Ø Satisfactory numeration, materials incentives,
financial incentives
Ø Possibility of future payment
|
Ø Inconsistent remuneration
Ø Change in tangible incentives
Ø Inequitable distribution of incentives among different
CHWs
|
|
Nonmonetary incentives that motivate CWHs
|
ü Community recognition
ü Acquisition of valued skills
ü Personal growth and development
ü Accomplishment
ü Peer support
ü Preferential treatment
ü Clear role
|
ü CHWs from outside of the country
ü Inadequate refresher training
ü Inadequate supervision
ü Lack of respect from HFs a staff
|
|
Community factors that motivate CHWs
|
ü Community involvement selection
ü Community organizations that support CHWs
ü Community involvement in CHWs training
ü Community information system
|
ü Inappropriate selection of CHWs
ü Lack of community involvement in CHWs selection, training
and support.
|
|
Factors motivate communities to support and stain CHWs
|
Ø Visible change
Ø Contribution to the community empowering
Ø CHWs associations
Ø Successful referral to health facilities
|
Ø Unclear role and expectation(preventive versus curative
care)
Ø Inappropriate CHWs behavior
Ø Failure to take community need into account
|
|
Factors that motivate MOH staff to support and sustain
CHWs
|
Ø Policy and legislation to support
Ø Visible change
Ø Government community finding for supervisory
activities
|
Ø Inadequate staff and supply
|
Maternal and New Born
Health Services
Community Health Workers identify and register women of
reproductive age (encourage family planning,), identify pregnant women and
encourage ANC, birth preparedness and facility based deliveries, identify women
and newborns with danger signs and refer them to health facility for care,
accompany women in labor to health facilities, encourage early postnatal
facility checks for both newborns and the mothers and report those activities
by using Use Rapid SMS (MOH, Rwanda 2011).
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