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