Working Conditions for Community Health Workers

IntraHealth International announces the publication of “Increasing Community Health Worker Productivity and Effectiveness: A Review of the Influence of the Work Environment” in the journal Human Resources for Health. In this new research article, policy-makers, program managers, researchers, and students will learn which factors in the work environment affect a community health worker’s performance and, ultimately, determine the effectiveness of community-based strategies.

Community health workers worldwide are taking on more and more responsibilities in their regions, say study authors Wanda Jaskiewicz and Kate Tulenko. The workers provide maternal and child health care, family planning, counseling and referrals for HIV and malaria, and many other services. As their assignments pile up and their role in local health care grows, more and more people depend on their productivity and efficiency.

But how many tasks can community health workers reasonably shoulder? How should their tasks be organized to maximize efficiency? And how many households can they be expected to be responsible for? There’s a lot of debate around those questions. One thing, though, is clear: when the workload becomes unwieldy, a worker’s productivity and work quality often suffer.

The work environment can directly affect a community health worker’s performance, Jaskiewicz and Tulenko found when they conducted a desk review of articles and reports on the subject.  Workers need regularly replenished supplies, medicines, and equipment in order to carry out their tasks effectively—and to keep the trust and respect of their communities. They also need support from the formal health system. High-quality supervision, often one of the weakest links in the community health worker program, is vital. Without it, morale and productivity drop.

Here are a few of the authors’ recommendations for creating work environments that lead to productive, effective community health workers:

  • Conduct operations research to determine the ideal number of tasks an organization’s workers can take on. Also determine the highest number of tasks workers can undertake while still working effectively.
  • Involve the workers in decisions about whether to add new services. Find out from them which services are most in demand and would be most valuable in their communities.
  • Conduct time-use studies to understand how community health workers use their time to carry out their assigned duties, as well as any obstacles they encounter.
  • Improve the supervisory system. Provide recognition and feedback, help solve problems, and link workers to the formal health sector. Solicit feedback from workers about what’s working and what must be improved.
  • Consider mobile technology as a way to help workers be more connected and communicative. Mobile phones can also give workers access to further training and help them order supplies and refer patients more efficiently.
  • Strengthen the human resources management systems to create working conditions that foster good performance.

While community health workers are expected to do more and more, they often don’t get the resources they need to do their jobs well. By establishing balanced, well-managed working environments, policy-makers and program managers can help community health workers do their best work and provide their patients with excellent care.

IntraHealth staff members Wanda Jaskiewicz and Kate Tulenko are the authors of “Increasing Community Health Worker Productivity and Effectiveness: A Review of the Influence of the Work Environment” in the journal Human Resources for Health, where the article has gained the designation of “highly accessed.” Read the full article here [412 kb PDF].