Limitation of Study
The major limitation of
this study was the unwillingness of some respondents to give true information
during data collection as it was intended to investigate the contribution of
incentives they receive on improvement of services they deliver to mothers and
newborns. Probing and encouragement was done by the researcher to divulge the necessary information to
respondents.
The findings from this
study was arguably limited by the fact that the study cannot claim to be truly
nationally representative because the study was conducted to CHWs in charge of
maternal and newborn health of only one district hospital among 46 district
hospitals country wide.
Theoretical Framework
The study was based on Maslow's Theory of Human Motivation.
This framework will contain aspects of other psychological theories of
motivation, corporate management models, and volunteer management models.
Applying Maslow's theory to existing corporate management models were
established the theory's relevance to management structures. Because volunteer
work differs from corporate work, the Theory of Human Motivation was adapted to
non-paid, volunteer work.
The framework was applied to major areas of existing CHW
programs in order to review the incentives, and ultimately, the incentives in
place. The goal of incentive structures should be to motivate CHWs to complete
their tasks effectively, while ensuring that they will stay committed with the
intervention. Motivation can be achieved in many ways, either extrinsically or
intrinsically. In analyzing an intervention, it is important to distinguish the
types of incentives motivating CHWs in charge of maternal and newborn health,
because they reflect the sustainability of the
program that can contribute to an improvement of maternal and newborn
health.
Conceptual Framework
Independent Variable
Dependent Variable
Maternal and newborn Health Services
performance
o Percentage per target
Community Health Workers Incentives
o Financial incentives of CHWs
o Non-financial incentives of CHWs' (equipment and materials)
o Membership in CHW's cooperatives
Figure 1: Conceptual Framework
Operational Definitions of
Terms
Community PBF: is mechanism of CHWs
motivation through their performance based financing. Payments made when proof
of the agreed level of performance, Community PBF guide details management at
different levels, the Sector Steering Committee oversees the implementation and
approves payment to the CHW Cooperative. Indicators entered at HC level into
web-based database after quarterly approval by committee with feedback.
This was measured by analyzing the level of agreement from one
to four meaning that: strongly agree (SA) = 4, agree (A) = 3, strondly disagree
(SD) = 2 then disagree (DA) = 1.
Provision of Equipment and Materials: The
community health workers in charge of maternal and newborn health are provided
with different tools and materials from government of Rwanda and different
partners local and international those help them to accomplish their tasks
those are bags, umbrella, timer, thermometer, balance, mobile phone, rain cost,
register for information recording, reporting register and the register for the
in reproductive age and pregnancy women. This was measured by analyzing the
level of agreement from one to four meaning that: strongly agree (SA ) =
4,agree (A) = 3, strongly disagree (SD) = 2 then disagree (DA) = 1.
CHWs Monthly Perdiem: This amount most of the
time paid by partners to strengthen the self-motivation based on monthly home
visits, daily accompaniment & key maternal health activities, timely
completion of a monthly report. This was measured by analyzing the level of
agreement from one to four meaning that: strongly agree (SA) = 4, agree (A) =
3, strongly disagree (SD) = 2 then disagree (DA) = 1.
Income Generation for Membership in CHW's
Cooperatives: All CHWs are organized in cooperatives and everyone is
supposed to benefit income generation from cooperative project. This was
measured by analyzing the level of agreement from one to four meaning that:
strongly agree (SA) = 4, agree (A) = 3, strongly disagree (SD) = 2 then
disagree (DA) = 1.
Maternal and Newborn Health Services: are the
tasks the CHWs in charge of maternal and newborn health are assigned to
accomplish. Those are almost 12 indicators seen in this research questionnaire.
The respondents gave the number then the surveyors made percentage after the
mean of measuring scare was calculated.
This variable was be measured using the scale as
follow:6=81-100% interpreted as high or very good performance, 5 = 61-80%
interpreted as good performance, 4 = 41-60 % interpreted as moderate or neuter
performance , 3 = 20-40% interpreted as low or poor performance, 2 = less than
20% very poor performance then after 1 is interpreted as not any activity
accomplished.
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