Timely Access to Maternal, Neonatal and Child Healthcare for rural communities in Rwanda: The Role of Community Health Workers
Abstract
Abstract
Introduction: In Rwanda, although there has been some progress in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. Improving equitable access to quality healthcare services for maternal, neonatal and child healthcare (MNCH), community-based maternal, neonatal and child healthcare (CBMNCH) depends upon using “community health workers” (CHWs). Yet CHWs program faces difficulties that upset delivery of the quality of the comprehensive package of services. Unfortunately, little is known about CHWs` performance and job satisfaction in the provision of CBMNCH.
Goal: The study aimed to provide insight into the performance and job satisfaction of CHWs for timely access to maternal, neonatal, and child healthcare for rural communities in Rwanda
Method: This quantitative cross-sectional study involved a survey of 500 sampled CHWs who are involved in CBMNCH in three selected rural districts of the southern province: Gisagara, Muhanga, and Ruhango district. The sample size in each district was calculated based on a district proportionate allocation sampling technique, probability proportional to size. The survey was conducted from June to September 2019. CHWs` job performance and job satisfaction were categorized as high, middle and low. Ordinal regression analysis was used to examine the correlates of CHWs` job performance and the determinants of their job satisfaction.
Results: CHWs who were more likely to report high performance on the job had more years of experience (2.51, pConclusion: The findings indicated that the managers of community health program and other stakeholders need to find on how to reduce CHWs heavy the workloads and how to improve the severe working conditions of CHWs when considering the assignment of their responsibilities to enable effective CBMNCH with good quality.
Keywords: Maternal, Health, Child, Access, Healthcare, Community, Worker, Rwanda