The Role of Leadership and its Relationship with the Performance of Community Health Volunteer: A Survey in Rural Indonesia

Background: Community Health Volunteers (CHVs) are the manifestation of community participation to solve health issues of the community, which is reflected through Integrated Services Post or known as Posyandu activities. Therefore, CHVs selection criteria need to be upgraded to support their performance in delivering community health services. This research aimed at identifying the relationship between the role of leadership and their performance in Posyandu activities. Method: This was a cross-sectional study conducted in Purwomartani village, Sleman, with a total of 68 respondents. Data were collected using validated questionnaires to evaluate the leadership and performance of healthy volunteers. The data were analyzed using Spearman's rank correlation. Results: The respondents comprised 100% females, 71.3% were aged above 41, and 82.4% were housewives, and 83.3% completed their education up to senior high school. The study revealed that 57.4% of respondents showed excellent performance before, during, and after the Posyandu activities. Bivariate analysis revealed that the role of leadership has a significant relationship with the performance of health volunteers (p<0.05). Conclusion: Training on leadership and effective communication is needed to support the role of CHVs to motivate the community to use the facilities for better health status.

Using a mobile application to improve pediatric presumptive TB identification in western Kenya

BACKGROUND: Early recognition of TB symptoms in children is critical in order to link children to appropriate testing and treatment. Healthcare workers (HCWs) in high TB burden countries are often overburdened with competing clinical priorities, leading to incomplete presumptive TB screening. We assessed if implementing a community health volunteer (CHV) led presumptive pediatric TB mobile android application (PPTBMAPP) in pediatric outpatient, primary care clinics in western Kenya would be feasible, appropriate, and effective.METHODS: We used a mixed-methods participatory, iterative approach to design and implement the PPTBMAPP during a 6-month period. We compared the proportion of children identified in presumptive TB and active TB disease registers out of all patients before and after the implementation of the intervention.RESULTS: Of the 1787 children aged ≤15 years screened using the PPTBMAPP, 376 (21%) met the criteria for presumptive TB. There was a statistically significant increase in the proportion of children to all patients in the presumptive TB registers (97/908, 10.7% vs. 160/989, 16.2%; P = 0.0005), and a trend towards an increase in the proportion of children to all patients in the TB case register (17/117, 14.5% vs. 15/83, 18.1%; P = 0.5). HCWs interviewed commented that the application sped up the presumptive TB screening process.CONCLUSION: Our CHV-led mobile screening intervention significantly increased presumptive TB notification. HCWs reported that the mobile screening intervention was feasible, appropriate, and effective.

Community Perception of Tuberculosis Management Program in Suburban Surabaya: A Qualitative Study

Tuberculosis (TB) is still one of the main infectious diseases in Indonesia. The national program, Directly Observed Treatment short course (DOTS), that began in 2014 is unable to deal with TB cases comprehensively. The community has an important role in TB management because they directly intersect with patients and public health. The aim of this study is to explore the condition of the TB management program. A descriptive qualitative study was conducted in three sub-districts with high cases of TB. A semi-structured interview was conducted with 25 participants drawn from the suburban TB task force, community health volunteer groups, Community health Nurses, and subdistrict officers. Results reveal four themes which affect the implementation of TB management programmes: volunteer shortage, do for humanitarian intention, the myth and stigma, providing social and economic support. In conclusion, communitybased TB management needs to be improve in the availability of budget, staff, training and resources while maintaining the ongoing work of the TB task force team. Keywords: Community-based management, Community Health Volunteer, Descriptive Qualitative, Humanitarian Intention, Social support, TB.

Understanding community health volunteer incentive preferences in Kenya

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.

Strengthening community health volunteers as a community empowerment in the reduction of HIV/AIDS stigma

Negative stigma of society is one of the inhibitory factors of HIV/AIDS promotion and prevention programs. The Community Health Volunteer HIV (CHV HIV) program represents a community attempt to reduce the negative stigma of society concerning HIV/AIDS. The purpose of this activity is the formation of CHV HIV activities which are expected to educate the Primary Health Care (PHC) patients who are childbearing age women and expectant mothers in HIV/AIDS prevention; to support the success of the Prevention of Mother to Child Transmission (PMTCT) program; to increase the participation of childbearing age women and expectant mothers in Voluntary Counselling and Testing (VCT), and to reduce the incidence rate of HIV. Community empowerment activities were conducted in 2018, from July until November in Sleman, District Istimewa Yogyakarta (DIY). These activities involved the socialization of HIV/AIDS programs and education about VCT for CHVs in cooperation with PHC and non-government organizations (NGOs). The CHVs provided counselling for childbearing age women and expectant mothers related to prevention of HIV/AIDS transmission. The results of these activities were the increasing of CHV knowledge about HIV/AIDS and the formation of twelve CHV HIV in Sleman, DIY. In conclusion, this activity effectively increases the participation of childbearing age women and expectant mothers in voluntary HIV tests, so that the formation of CHV HIV could not only involve adult age volunteers but also adolescents.