Valuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative study

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dc.contributor.authorDaniels, Karenen_ZA
dc.contributor.authorSanders, Daviden_ZA
dc.contributor.authorDaviaud, Emmanuelleen_ZA
dc.contributor.authorDoherty, Tanyaen_ZA
dc.date.accessioned2015-11-11T14:29:39Z
dc.date.available2015-11-11T14:29:39Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND: Within the integrated community case management of childhood illnesses (iCCM) programme, the traditional health promotion and prevention role of community health workers (CHWs) has been expanded to treatment. Understanding both the impact and the implementation experience of this expanded role are important. In evaluating UNICEF’s implementation of iCCM, this qualitative case study explores the implementation experience in Ghana. Methods and FINDINGS: Data were collected through a rapid appraisal using focus groups and individual interviews during a field visit in May 2013 to Accra and the Northern Region of Ghana. We sought to understand the experience of iCCM from the perspective of locally based UNICEF staff, their partners, researchers, Ghana health services management staff, CHWs and their supervisors, nurses in health facilities and mothers receiving the service. Our analysis of the findings showed that there is an appreciation both by mothers and by facility level staff for the contribution of CHWs. Appreciation was expressed for the localisation of the treatment of childhood illness, thus saving mothers from the effort and expense of having to seek treatment outside of the village. Despite an overall expression of value for the expanded role of CHWs, we also found that there were problems in supporting and sustaining their efforts. The data showed concern around CHWs being unpaid, poorly supervised, regularly out of stock, lacking in essential equipment and remaining outside the formal health system. CONCLUSIONS: Expanding the roles of CHWs is important and can be valuable, but contextual and health system factors threaten the sustainability of iCCM in Ghana. In this and other implementation sites, policymakers and key donors need to take into account historical lessons from the CHW literature, while exploring innovative and sustainable mechanisms to secure the programme as part of a government owned and government led strategy.en_ZA
dc.identifier.apacitationDaniels, K., Sanders, D., Daviaud, E., & Doherty, T. (2015). Valuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative study. <i>PLoS One</i>, http://hdl.handle.net/11427/14937en_ZA
dc.identifier.chicagocitationDaniels, Karen, David Sanders, Emmanuelle Daviaud, and Tanya Doherty "Valuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative study." <i>PLoS One</i> (2015) http://hdl.handle.net/11427/14937en_ZA
dc.identifier.citationDaniels, Karen, et al. "Valuing and Sustaining (or Not) the Ability of Volunteer Community Health Workers to Deliver Integrated Community Case Management in Northern Ghana: A Qualitative Study." PloS one 10.6 (2015). doi:10.1371/journal.pone.0126322en_ZA
dc.identifier.ris TY - Journal Article AU - Daniels, Karen AU - Sanders, David AU - Daviaud, Emmanuelle AU - Doherty, Tanya AB - BACKGROUND: Within the integrated community case management of childhood illnesses (iCCM) programme, the traditional health promotion and prevention role of community health workers (CHWs) has been expanded to treatment. Understanding both the impact and the implementation experience of this expanded role are important. In evaluating UNICEF’s implementation of iCCM, this qualitative case study explores the implementation experience in Ghana. Methods and FINDINGS: Data were collected through a rapid appraisal using focus groups and individual interviews during a field visit in May 2013 to Accra and the Northern Region of Ghana. We sought to understand the experience of iCCM from the perspective of locally based UNICEF staff, their partners, researchers, Ghana health services management staff, CHWs and their supervisors, nurses in health facilities and mothers receiving the service. Our analysis of the findings showed that there is an appreciation both by mothers and by facility level staff for the contribution of CHWs. Appreciation was expressed for the localisation of the treatment of childhood illness, thus saving mothers from the effort and expense of having to seek treatment outside of the village. Despite an overall expression of value for the expanded role of CHWs, we also found that there were problems in supporting and sustaining their efforts. The data showed concern around CHWs being unpaid, poorly supervised, regularly out of stock, lacking in essential equipment and remaining outside the formal health system. CONCLUSIONS: Expanding the roles of CHWs is important and can be valuable, but contextual and health system factors threaten the sustainability of iCCM in Ghana. In this and other implementation sites, policymakers and key donors need to take into account historical lessons from the CHW literature, while exploring innovative and sustainable mechanisms to secure the programme as part of a government owned and government led strategy. DA - 2015 DB - OpenUCT DO - 10.1371/journal.pone.0126322 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Valuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative study TI - Valuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative study UR - http://hdl.handle.net/11427/14937 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14937
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0126322
dc.identifier.vancouvercitationDaniels K, Sanders D, Daviaud E, Doherty T. Valuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative study. PLoS One. 2015; http://hdl.handle.net/11427/14937.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2015 Daniels et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherGhanaen_ZA
dc.subject.otherHealth services researchen_ZA
dc.subject.otherNursesen_ZA
dc.subject.otherQualitative studiesen_ZA
dc.titleValuing and sustaining (or not) the ability of volunteer community health workers to deliver integrated community case management in Northern Ghana: A qualitative studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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