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Table 1 Measures and definitions of Community Health Worker performance in the generic logic model

From: A Community Health Worker “logic model”: towards a theory of enhanced performance in low- and middle-income countries

Results Classification Measures Definition
Outputs Indirect Knowledge Degree to which the CHW has the theoretical or practical understanding of the function and tasks assigned to him/her
Competencies Degree to which the CHW has the skills necessary to carry out the tasks assigned to him/her
Motivation An individual’s degree of willingness to exert and maintain effort on assigned tasks
Morale The mental and emotional condition (as of enthusiasm, confidence, etc.) of an individual CHW with regard to the function or tasks at hand
Self-efficacy/esteem A CHW’s confidence, belief in his/her ability to produce an expected, desired result
Satisfaction Degree to which CHWs derive personal satisfaction from serving the community, providing good quality services
Direct Absenteeism Rate at which those CHWs who are supposed to be delivering services habitually fail to appear to carry out their tasks
Service delivery Quantity and quality of promotional, preventive, and curative services CHWs provide to community members
Responsiveness The degree to which an individual CHW responds to the needs of an individual client or group within a reasonable time period
Productivity A CHW’s total output per unit of total input
Developmental Attrition The rate at which practicing CHWS resign, retire, or abandon their positions over time
Advancement The rate at which CHWs are advancing in their skills, competencies, formal responsibilities, and formal status within the community and the formal health system over time
Outcomes CHW-attributable changes among individual clients Access Client’s physical and social access to essential services delivered by CHWs
Knowledge of service availability Client’s ability to identify the location of CHWs and the services they provide
Health care-seeking behavior Client in need of essential services and with access to CHWs is routinely seeking and using promotional, preventive and/or curative services CHWs offer
Health-promoting behavior in the home Client has adopted health-promoting behaviors in the home as a result of contact with CHWs
Satisfaction Client’s reported degree of satisfaction with the services rendered by CHWs
Cost savings Money not spent by client that he/she otherwise would have spent (on transportation and other items) in the absence of a CHW
Health Change in client’s state of illness, wellness, survival
CHW-attributable changes in the community Credibility Degree to which the community considers CHWs to be making an important and valuable contribution to the health and well-being of the community
Prestige Status the community confers upon CHWs as a result of their selection and/or resulting from the quantity and quality of the services they deliver to community members
Cost savings Money not spent by a community that it otherwise would have been spent in the absence of a CHW to ensure its members secure health services
Change in community functioning Changes in a community’s structure, processes, and behaviors resulting from its interaction with a CHW
Social cohesion Change in the manner in which community members work towards achieving a goal or satisfy the emotional needs of its members resulting from its interaction with a CHW
Community satisfaction Community’s reported degree of satisfaction with the services rendered by CHWs
Change in community health Change in community’s state of illness, wellness, survival
CHW-attributable changes in the health system Credibility Degree to which health system actors consider CHWs to be making an important and valuable contribution to the health and well-being of the community and the sound functioning of the health system
Prestige Status the health system confers upon CHWs as a result of their selection and/or resulting from the quantity and quality of the services they deliver
Cost savings Money not spent by the health system that it otherwise would have spent in the absence of a CHW to ensure the system was delivering high quality health services
Change in health system functioning Changes in health system structures, processes, and behaviors resulting from its interaction with a CHW
Health system satisfaction Health system actors’ reported degree of satisfaction with the services rendered by CHWs
Impact CHW-attributable changes in health at the population level Morbidity Change in the prevalence of serious illness in the population served by CHWs
Mortality Change in the level of mortality in the population served by CHWs
Fertility rate The ratio of live births in a CHW-served area to the population of that area expressed per 1,000 population per year
Equity Degree to which access, coverage, or morbidity/mortality levels vary among different socio-economic or socially defined sub-groups in the population served by CHWs
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