Factors associated with child health service delivery by female community health volunteers in Nepal: Findings from a national survey
Abstract Background: Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been a lot of documented studies and reports, rarely has been explored the status and factors associated with the child health service provided by these volunteers. The aim of this study was to identify the factors associated with the child health service delivery by FCHVs.Methods : A national survey was conducted in 2014 in Nepal that included 4,302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. The data was extracted and the association of child health services with characteristics was examined using Chi-square test (χ2) followed by logistic regression. Results: Overall, 62.6% of FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted health mothers’ group meeting, involved in local committees and those who supported antenatal care and outreach clinics related activities had higher odds of providing child health services. Similarly, FCHVs equipped with the stock of Cotrimoxazole tablet, Zinc tablet, Oral Rehydration Salt packets were more likely to provide child health services. The province-wise analysis showed that FCHVs from Province 5 and Sudur Paschim Province were more likely to provide child health services compared to their counterparts from province 1. Technology-wise, FCHVs who were using mobile were more likely to provide child health services.Conclusions : FCHVs are important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs, availability of key commodities, involvement of FCHVs in regular health mothers’ group meeting, use of mobile phone, involvement in other public health programs and social networks, and utilization of the FCHV fund need to be taken into consideration.