scholarly journals Understanding community health volunteer incentive preferences in Kenya

2021 ◽  
Author(s):  
◽  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Community Health Services ◽  
Experiment Study ◽  
Health Extension Workers ◽  
Qualitative And Quantitative ◽  
Community Health Volunteers ◽  
Community Health Volunteer

In Kenya, community health services are implemented through community health units. Community health volunteers (CHVs) who serve these units are chosen by the community and trained by community health extension workers. This brief summarizes qualitative and quantitative findings from the Frontline Health project’s discrete choice experiment study in Kenya, which aimed to understand incentive preferences of CHVs with the aim of improving motivation, performance, and retention of CHVs.

scholarly journals Incentive preferences for community health volunteers in Kenya: findings from a discrete choice experiment

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048059
Author(s):  
Timothy Abuya ◽  
Daniel Mwanga ◽  
Melvin Obadha ◽  
Charity Ndwiga ◽  
George Odwe ◽  
...  
Keyword(s):  
Community Health ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Financial Incentives ◽  
Choice Experiment ◽  
Qualitative Interviews ◽  
Working Environment ◽  
Nominal Group ◽  
Community Health Volunteers ◽  
Trade Offs

BackgroundCommunity health volunteers (CHVs) play crucial roles in enabling access to healthcare at the community levels. Although CHVs are considered volunteers, programmes provide financial and non-financial incentives. However, there is limited evidence on which bundle of financial and non-financial incentives are most effective for their improved performance.MethodsWe used a discrete choice experiment (DCE) to understand incentive preferences of CHVs with the aim to improve their motivation, performance and retention. Relevant incentive attributes were identified through qualitative interviews with CHVs and with their supervisors. We then deployed a nominal group technique to generate and rank preferred attributes among CHVs. We developed a DCE based on the five attributes and administered it to 211 CHVs in Kilifi and Bungoma counties in Kenya. We used mixed multinomial logit models to estimate the utility of each incentive attribute and calculated the trade-offs the CHWs were willing to make for a change in stipend.ResultsTransport was considered the incentive attribute with most relative importance followed by tools of trade then monthly stipend. CHVs preferred job incentives that offered higher monthly stipends even though it was not the most important. They had negative preference for job incentives that provided award mechanisms for the best performing CHVs as compared with jobs that provided recognition at the community level and preferred job incentives that provided more tools of trade compared with those that provided limited tools.ConclusionA bundled incentive of both financial and non-financial packages is necessary to provide a conducive working environment for CHVs. The menu of options relevant for CHVs in Kenya include transport, tools of trade and monthly stipend. Policy decisions should be contextualised to include these attributes to facilitate CHW satisfaction and performance.

scholarly journals Discrete choice experiment for eliciting preference for health services for patients with ALS and their informal caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katy Tobin ◽  
Sinead Maguire ◽  
Bernie Corr ◽  
Charles Normand ◽  
Orla Hardiman ◽  
...  
Keyword(s):  
Health Services ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Strong Preference ◽  
Multidisciplinary Teams ◽  
Relative Importance ◽  
Trade Offs ◽  
Als Patients ◽  
The Impact

Abstract Background Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative condition with a mean life expectancy of 3 years from first symptom. Understanding the factors that are important to both patients and their caregivers has the potential to enhance service delivery and engagement, and improve efficiency. The Discrete Choice Experiment (DCE) is a stated preferences method which asks service users to make trade-offs for various attributes of health services. This method is used to quantify preferences and shows the relative importance of the attributes in the experiment, to the service user. Methods A DCE with nine choice sets was developed to measure the preferences for health services of ALS patients and their caregivers and the relative importance of various aspects of care, such as timing of care, availability of services, and decision making. The DCE was presented to patients with ALS, and their caregivers, recruited from a national multidisciplinary clinic. A random effects probit model was applied to estimate the impact of each attribute on a participant’s choice. Results Patients demonstrated the strongest preferences about timing of receiving information about ALS. A strong preference was also placed on seeing the hospice care team later rather than early on in the illness. Patients also indicated their willingness to consider the use of communication devices. Grouping by stage of disease, patients who were in earlier stages of disease showed a strong preference for receipt of extensive information about ALS at the time of diagnosis. Caregivers showed a strong preference for engagement with healthcare professionals, an attribute that was not prioritised by patients. Conclusions The DCE method can be useful in uncovering priorities of patients and caregivers with ALS. Patients and caregivers have different priorities relating to health services and the provision of care in ALS, and patient preferences differ based on the stage and duration of their illness. Multidisciplinary teams must calibrate the delivery of care in the context of the differing expectations, needs and priorities of the patient/caregiver dyad.

scholarly journals Current status of antenatal care of pregnant women—8 provinces in China, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
First Trimester ◽  
Community Health Services ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square ◽  
Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

scholarly journals Patient experience surveys for children’s community health services: A scoping review

2021 ◽  
pp. 136749352110058
Author(s):  
Helen J Nelson ◽  
Catherine Pienaar ◽  
Anne M Williams ◽  
Ailsa Munns ◽  
Katie McKenzie ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Patient Experience ◽  
Scoping Review ◽  
Emotional Support ◽  
Community Health Services ◽  
Experience Of Care ◽  
Healthcare Experience

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.

scholarly journals How Do Patients Want Us to Use the Computer During Medical Encounters?—A Discrete Choice Experiment Study

2021 ◽  
Author(s):  
Cédric Lanier ◽  
Melissa Dominicé Dao ◽  
Dave Baer ◽  
Dagmar M. Haller ◽  
Johanna Sommer ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Primary Care Physicians ◽  
Skills Training ◽  
Experiment Study ◽  
Visual Contact ◽  
Patient Centered ◽  
Clinical Communication ◽  
French Speaking

Abstract Background Primary care physicians (PCPs) now widely use electronic health records (EHRs) during medical encounters. Experts in clinical communication issued recommendations for a patient-centered use of EHRs. However, they have never been validated by patients themselves. Objective To explore patients’ preferences regarding physicians’ EHR-related behaviors. Design Discrete choice experiment study. Patients French-speaking patients waiting for a medical consultation at two outpatient clinics in Geneva, Switzerland. Main Measures We invited patients to watch videos displaying 2 or 3 variations of four specific EHR-related behaviors and asked them to indicate which one they preferred. EHR-related behaviors were (1) typing: continuous/intermittent/handwriting in biomedical or psychosocial focused consultations; (2) maintaining contact while typing: visual/verbal/both; (3) signposting the use of EHR: with/without; (4) position of physicians’ hands and bust: on the keyboard and towards the patient/away from the keyboard and towards the patient/on the keyboard and towards the screen. Key Results Three hundred thirty-six patients participated (response rate 61.4%). They preferred intermittent typing versus handwriting or continuous typing for biomedical issues (32.7%; 95% CI: 26.0–40.2% vs 31.6%; 95% CI: 24.9–39.0% or 14.9%; 95% CI: 10.2–21.1%) and psychosocial issues (38.7%; 95% CI: 31.6–46.3% vs 24.4% 95% CI: 18.4–31.5% or 17.9%; 95% CI; 12.7–24.4%). They favored visual and verbal contact (38.9%; 95% CI: 31.9–46.3%) over verbal (30.3%; 95% CI: 23.9–37.5%) or visual contact only (11.4%; 95% CI: 7.5–17.1%) while the doctor was typing. A majority preferred signposting the use of EHR versus no signposting (58.9%; 95% CI: 53.5–64.0% vs 34.8%; 95% CI: 29.9–40.1%). Finally, half of the patients (49.7%; 95% CI: 42.0–57.4%) favored the position with the physician’s bust towards the patient and hands away from the keyboard. Conclusions Our study shows that patients’ preferences regarding EHR-related behaviors are in line with most experts’ recommendations. Such recommendations should be more consistently integrated into under- and postgraduate communication skills training.

COMMUNITY HEALTH SERVICES

1971 ◽  
Vol 20 (6) ◽  
pp. 545
Author(s):  
ROSELLA. CUNNINGHAM
Keyword(s):  
Health Services ◽  
Community Health ◽  
Community Health Services

COMMUNITY HEALTH SERVICES

1970 ◽  
Vol 19 (6) ◽  
pp. 546
Author(s):  
Hodgman ◽  
Callahan Eileen
Keyword(s):  
Health Services ◽  
Community Health ◽  
Community Health Services
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