scholarly journals Village health workers as health diplomats: negotiating health and study participation in a malaria elimination trial in The Gambia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yoriko Masunaga ◽  
Joan Muela Ribera ◽  
Fatou Jaiteh ◽  
Daniel H. de Vries ◽  
Koen Peeters Grietens

Abstract Background Although many success stories exist of Village Health Workers (VHWs) improving primary health care, critiques remain about the medicalisation of their roles in disease-specific interventions. VHWs are placed at the bottom of the health system hierarchy as cheap and low-skilled volunteers, irrespective of their highly valued social and political status within communities. In this paper, we shed light on the political role VHWs play and investigate how this shapes their social and medical roles, including their influence on community participation. Method The study was carried out within the context of a malaria elimination trial implemented in rural villages in the North Bank of The Gambia between 2016 and 2018. The trial aimed to reduce malaria prevalence by treating malaria index cases and their potentially asymptomatic compound members, in which VHWs took an active role advocating their community and the intervention, mobilising the population, and distributing antimalarial drugs. Mixed-methods research was used to collect and analyse data through qualitative interviews, group discussions, observations, and quantitative surveys. Results and discussion We explored the emic logic of participation in a malaria elimination trial and found that VHWs played a pivotal role in representing their community and negotiating with the Medical Research Council to bring benefits (e.g. biomedical care service) to the community. We highlight this representative role of VHWs as ‘health diplomats’, valued and appreciated by community members, and potentially increasing community participation in the trial. We argue that VHWs aspire to be politically present and be part of the key decision-makers in the community through their health diplomat role. Conclusion It is thus likely that in the context of rural Gambia, supporting VHWs beyond medical roles, in their social and political roles, would contribute to the improved performance of VHWs and to enhanced community participation in activities the community perceive as beneficial.

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Regina M. Thetsane ◽  
◽  
Maseabata V. Ramathebane ◽  
Motšelisi C. Mokhethi ◽  
Tiisetso Makatjane

1987 ◽  
Vol 81 (sup1) ◽  
pp. 116-123 ◽  
Author(s):  
Harrison C. Spencer ◽  
Dan C. O. Kaseje ◽  
Jacquelin M. Roberts ◽  
Alan Y. Huong

1983 ◽  
Vol 13 (3) ◽  
pp. 105-108 ◽  
Author(s):  
J Patrick Vaughan ◽  
Gill Walt

2013 ◽  
Vol 50 (4) ◽  
pp. 480-486 ◽  
Author(s):  
Shreedhar Paudel ◽  
Nadege Gilles ◽  
Sigrid Hahn ◽  
Braden Hexom ◽  
Ramaswamy Premkumar ◽  
...  

2020 ◽  
Vol 103 (6) ◽  
pp. 1209-1215
Author(s):  
Charles Moon ◽  
Faraz Alizadeh ◽  
Gloria Fung Chaw ◽  
Mary Immaculate Mulongo ◽  
Kenneth Schaefle ◽  
...  

2019 ◽  
Vol 27 (3) ◽  
pp. 24-33
Author(s):  
Nam Nguyen ◽  
Trang Nguyen ◽  
Van Truong ◽  
Kim Dang ◽  
Nina Siman ◽  
...  

Community health workers (in Vietnam referred to as village health workers) have the potential to play a key role in expanding access to evidence-based tobacco use treatment. We conducted a cluster randomized controlled trial in community health centers in Vietnam that compared the effect of provider advice and cessation assistance (i.e. brief counseling and patient education materials) (BC) vs. BC + three sessions of in-person counseling delivered by a village health worker (BC+R) on providers’ and village health workers’ adherence to tobacco use treatment guidelines. All village health workers and health care providers received training. This paper presents data on the effect of the intervention on village health workers’ adherence to tobacco use treatment guidelines, including asking about tobacco use, advising smokers to quit, offering assistance and their attitude, norms, and self-efficacy related to tobacco use treatment. We examined changes in adherence to tobacco use treatment guidelines before and 12 months after the intervention among 89 village health workers working in the 13 community health centers enrolled in the BC+R study condition. Village health workers’ adherence to tobacco use treatment guidelines increased significantly. Village health workers were more likely to ask about tobacco use (3.4% at baseline, 32.6% at 12 months), offer advice to quit (4.5% to 48.3%) and offer assistance (1.1% to 38.2%). Perceived barriers to treating tobacco use decreased significantly. Self-efficacy and attitudes towards treating tobacco use improved significantly. Increased adherence to tobacco use treatment guidelines was associated with positive attitudes towards their role in delivering tobacco use treatment and increasing awareness of the community health center smoke-free policy. The findings suggest that, with training and support systems, village health workers can extend their role to include smoking cessation services. This workforce could represent a sustainable resource for supporting smokers who wish to quit.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sacha C. Hauc ◽  
Dolley Tshering ◽  
Josemari Feliciano ◽  
Agata M. P. Atayde ◽  
Layla M. Aboukhater ◽  
...  

2019 ◽  
Vol 31 (5) ◽  
pp. 433-442
Author(s):  
Dolley Tshering ◽  
Phudit Tejativaddhana ◽  
Taweesak Siripornpibul ◽  
Mary Cruickshank ◽  
David Briggs

Village health workers (VHWs) are the first contact extending vital health services to unreached and underserved communities in Bhutan. VHWs truly embody the principles of primary health care and are effective catalysts in promoting community health. This study identifies and confirms factors motivating VHWs to remain in the health care system. This is a quantitative study with a cross-sectional survey design. Two-stage cluster sampling was used with VHWs from 12 districts representing 3 regions of Bhutan. Data were collected using pretested semistructured questionnaires. Confirmatory factor analysis was used for data analysis. Findings reveal a 4-factor model of motivations among VHWs that includes social, personal, job related, and organizational factors. Among these, the social factor most significantly motivates VHWs to remain in the health care system. VHW motivation can be further fostered by providing a holistic combination of financial and nonfinancial incentives that recognize intrinsic needs and empower innate altruism.


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