S/N | Factor | Description of determinant | Studies |
---|---|---|---|
Community health worker (CHW) characteristics | |||
1 | Demographic factors | Female CHWs performed better than their male counterparts, married CHWs gave a higher performance than others, having fewer household duties encourages CHWs to work more actively and reduces the dropout rate, longer work experience, good educational status, availability of supporters for household chores, and appropriate sanitation practices | Kawakatsu et al. 2015; Bagonza et al. 2014; Wanduru et al. 2016 |
2 | CHW confidence and competence | CHWs may have lacked confidence in the guidelines, particularly, the ability of CHWs to obtain an accurate history of convulsions. CHW able to do RDT confidently and effectively on the other hand | Kelly et al. 2001; Mubi et al. 2011 |
Community factors | |||
1 | Community factors | Mobilization of communities by the local leaders and confidence of the community in medicines used, lack of community appreciation for age restrictions of children treated, poor community participation, poor cooperation from caregivers, social prestige, community support in terms of feedback and rewards, training institute, poor performance of basic household health practices | Kalyango et al. 2012; Druetz et al. 2015; Chinbuah et al. 2013; Kawakatsu et al. 2015; Perez et al. 2009; Banek et al. 2015; Nsona et al. 2012 |
2 | CHW service utilization | CHWs rarely use for malaria interventions and only poor household using them in mostly in rural | Druetz et al. 2015; Kisia et al. 2012; Kelly et al. 2001; Yeboah-Antwi et al. 2010 |
Health system factors | |||
1 | Feedback | Some CHWs did not receive timely feedback from their supervisors. Community support in the form of feedback and rewards | Bagonza et al. 2014; Kalyango et al. 2012 |
2 | Training | Adequately continuously trained and appropriately resourced CHWs are really motivated to perform their tasks like interpreting RDTs, and give treatment for Malaria. clearly defined roles for CHAs and supervisors | Kalyango et al. 2012; Chanda et al. 2011; MOH-Rwanda 2009; Yeboah-Antwi et al. 2010; Druetz et al. 2015; Perez et al. 2009; Nsona et al. 2012; Wanduru et al. 2016 |
3 | Stocks and supplies | The need for continuous supplies of drugs and stocks is cardinal for enhancing success of CHWs for malaria | Kelly et al. 2001; Chanda et al. 2011; Kalyango et al. 2012; Searle et al. 2016; Druetz et al. 2015; Perez et al. 2009; Chinbuah et al. 2013; Banek et al. 2015; Nsona et al. 2012 |
4 | Job aids | Complexity of guidelines was an important reason for deficiencies managing sick children. These should be in local language possibly | Chinbuah et al. 2013; Kelly et al. 2001; Nsona et al. 2012 |
5 | Supervision | High quality support supervision from supervisors from formal health system who should have adequate health knowledge to conduct routine supervisions to sustain a high performance is necessary to improve the performance of CHWs in malaria interventions | Bagonza et al. 2014; Kawakatsu et al. 2015; Perez et al. 2009; Kelly et al. 2001; Druetz et al. 2015; Chinbuah et al. 2013; Nsona et al. 2012; Wanduru et al. 2016 |
6 | Funding | CHW performance is hard to achieve and to maintain without sufficient consideration for funding | Druetz et al. 2015; Banek et al. 2015; Nsona et al. 2012 |
7 | Transport | Distance and lack of transport refund affects their performance | Kalyango et al. 2012; Perez et al. 2009 |
8 | Remuneration/motivation | Lack of incentives demotivates them and CHWs asking for consideration | Druetz et al. 2015; Perez et al. 2009; Kalyango et al. 2012; Chinbuah et al. 2013; Banek et al. 2015; Nsona et al. 2012; Wanduru et al. 2016 |
9 | Health professional support | CHWs work not trusted by the health professional staff | Kalyango et al. 2012 |
10 | Workload | CHWs performed poorly due to large population coverage and multiple tasks | Yeboah-Antwi et al. 2010; Kalyango et al. 2012; Searle et al. 2016; Perez et al. 2009; Kelly et al. 2001; Bagonza et al. 2014; Wanduru et al. 2016 |
11 | Evaluation environment | Evaluated in a different setting other than area of usual practice | Kelly et al. 2001 |
12 | Reporting | CHW performance may have been underestimated because a failure to document was interpreted as an error—missing data | Kelly et al. 2001; Nsona et al. 2012 |
13 | Program coordination | Poor CHW program coordination at all levels affects performance negatively | Nsona et al. 2012 |