Table 3 Risk factors for retention of a cohort of 542 volunteer community health workers, Dhaka urban slums, 2009 a
Independent variables | Model 1: Sociodemographic characteristics | Model 2: Addition of motivational factors | Model 3: Addition of organizational inputs | Model 4: Addition of competitive factors | Model 5: Final model |
|---|---|---|---|---|---|
Partially adjusted RR (95% CI) | Partially adjusted RR (95% CI) | Partially adjusted RR (95% CI) | Partially adjusted RR (95% CI) | Adjusted RR (95% CI) | |
(1) | (2) | (3) | (4) | (5) | |
Sociodemographic characteristics | |||||
Age | |||||
>25 yr of age | 1.00 | 1.00 | 1.00 | 1.00 | |
25-45 yr of age | 1.08 (0.92 to 1.27) | 1.08 (0.93 to 1.27) | 1.09 (0.93 to 1.28) | 1.06 (0.91 to 1.25) | |
> 45 yr of age | 1.06 (0.85 to 1.32) | 1.06 (0.84 to 1.32) | 1.05 (0.84 to 1.31) | 1.04 (0.83 to 1.30) | |
Marital status | |||||
Unmarried | 0.74 (0.42 to 1.30) | 0.80 (0.46 to 1.38) | 0.88 (0.54 to 1.43) | 0.85 (0.52 to 1.40) | |
Married | 1.00 | 1.00 | 1.00 | 1.00 | |
Widow, divorced, or separated | 1.02 (0.89 to 1.16) | 1.02 (0.89 to 1.18) | 1.02 (0.88 to 1.18) | 1.02 (0.88 to 1.18) | |
Primary education complete or above | 0.97 (0.87 to 1.07) | 0.97 (0.87 to 1.08) | 0.96 (0.87 to 1.07) | 0.96 (0.86 to 1.07) | |
Household size | 1.02 (0.99 to 1.04) | 1.01 (0.99 to 1.04) | 1.01 (0.99 to 1.04) | 1.02 (0.99 to 1.04) | |
Duration of stay in the slum | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
<10 yr | 1.11c (0.98 to 1.25) | 1.10 (0.98 to 1.24) | 1.08 (0.96 to 1.22) | 1.07 (0.95 to 1.20) | 1.08 (0.96 to 1.21) |
10-20 yr | 1.12c (0.98 to 1.26) | 1.11c (0.98 to 1.25) | 1.10 (0.97 to 1.24) | 1.09 (0.96 to 1.23) | 1.11c (0.99 to 1.25) |
>20 yr | |||||
Household asset quintiles | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Poorest | 1.16b (1.01 to 1.33) | 1.14c (0.99 to 1.31) | 1.15b (1.00 to 1.32) | 1.13c (0.98 to 1.29) | 1.13c (0.99 to 1.29) |
Lower middle | 1.05 (0.90 to 1.23) | 1.06 (0.91 to 1.23) | 1.07 (0.92 to 1.25) | 1.07 (0.92 to 1.24) | 1.05 (0.91 to 1.22) |
Middle | 1.08 (0.92 to 1.26) | 1.06 (0.90 to 1.25) | 1.06 (0.91 to 1.25) | 1.05 (0.90 to 1.23) | 1.04 (0.89 to 1.22) |
Upper middle | 1.12 (0.97 to 1.31) | 1.10 (0.94 to 1.28) | 1.12 (0.96 to 1.29) | 1.12 (0.97 to 1.30) | 1.12c (0.98 to 1.28) |
Richest | |||||
Household loan status | 1.04 (0.95 to 1.13) | 1.01 (0.93 to 1.10) | 1.00 (0.92 to 1.09) | 0.95 (0.86 to 1.04) | |
Motivational factors | |||||
Family disapproval | 1.10c (1.00 to 1.22) | 1.10c (0.99 to 1.21) | 1.12b (1.01 to 1.25) | 1.12b (1.01 to 1.24) | |
Positive family attitude | 0.98 (0.87 to 1.11) | 0.99 (0.87 to 1.12) | 0.99 (0.87 to 1.11) | ||
Monthly CHW income | |||||
<US$ 5.92 | 1.00 | 1.00 | 1.00 | ||
US$ 5.92 to US$ 7.64 | 1.03 (0.90 to 1.17) | 1.02 (0.89 to 1.16) | 1.01 (0.88 to 1.15) | ||
>US$ 7.64 | 1.09c (0.99 to 1.20) | 1.07 (0.97 to 1.18) | 1.06 (0.96 to 1.17) | ||
Joined with expectation of income | 1.02 (0.93 to 1.12) | 1.02 (0.93 to 1.12) | 1.02 (0.93 to 1.12) | 1.04 (0.95 to 1.14) | |
Change in social prestige | 0.90c (0.80 to 1.02) | 0.91 (0.80 to 1.02) | 0.90c (0.80 to 1.02) | 1.0 | |
Less than before | 1.00 | 1.00 | 1.00 | 0.91c (0.81 to 1.02) | |
No change | 0.95 (0.86 to 1.05) | 0.93 (0.84 to 1.03) | 0.94 (0.85 to 1.04) | 0.95 (0.86 to 1.05) | |
More than before | |||||
Joined with expectation of social recognition | 0.92 (0.82 to 1.02) | 0.92 (0.82 to 1.03) | 0.93 (0.83 to 1.03) | 0.94 (0.85 to 1.04) | |
Harassed while working in the community | 1.12c (1.00 to 1.26) | 1.11c (0.98 to 1.24) | 1.08 (0.96 to 1.21) | ||
Community approval | 1.02 (0.91 to 1.15) | 1.02 (0.91 to 1.14) | 1.01 (0.90 to 1.14) | 1.00 (0.89 to 1.11) | |
Positive community appraisal | 1.39b (1.05 to 1.84) | 1.39b (1.06 to 1.83) | 1.42b (1.08 to 1.87) | 1.45b (1.10 to 1.91) | |
Effect of CHW role on other income sources | 0.88 (0.73 to 1.05) | 0.91 (0.76 to 1.08) | 0.85c (0.70 to 1.02) | 0.85c (0.71 to 1.03) | |
Difficult to run family without CHW income | 0.97 (0.88 to 1.07) | 0.98 (0.89 to 1.08) | 1.01 (0.91 to 1.12) | ||
Organizational inputs | |||||
Village organization membership | 1.00 (0.91 to 1.10) | 0.95 (0.86 to 1.05) | |||
Attending refresher training regularly | 2.13b (1.03 to 4.39) | 2.17b (1.04 to 4.52) | 2.25b (1.08 to 4.71) | ||
Competitive factors | |||||
Conflict with household responsibilities | 0.98 (0.85 to 1.12) | 0.98 (0.86 to 1.13) | |||
Competition with other providers | 1.01 (0.87 to 1.18) | 1.01 (0.88 to 1.16) | |||
Competition with other employment | 1.09c (1.00 to 1.20) | 1.08c (0.99 to 1.18) | |||
Involvement with other NGOs | 1.15b (1.03 to 1.28) | 1.13b (1.04 to 1.23) | |||
Working for other health program | 0.80c (0.63 to 1.01) | 0.81c (0.64 to 1.02) |