ASSESSMENT OF FACTORS INFLUENCING PERFORMANCE OF COMMUNITY HEALTH WORKERS IN HEALTH CARE DELIVERY IN MITYANA DISTRICT, UGANDA A Postgraduate research dissertation submitted to the Institute of Health Policy and Management in partial fulfillment of the requirements for the award of Masters in Public Health of International Health Sciences University NSHIMYE ANGELA (2009-MPH-FT.002) DECEMBER , 2012 1 DECLARATION I, Nshimye Angela, hereby declare that this research is my own original work and has never been submitted by any other person to this or any other University or institution for any academic award. Signature………………………………………..Date………………………………… 2 DEDICATION I dedicate this piece of work to all the people who helped me throughout my study time especially my parents. 3 APPROVAL I certify that this dissertation on Factors Influencing Performance of Community Health Workers has been composed by Nshimye Angella under my supervision and examination for the award of Masters of Public Health of International Health Sciences University. Name of Supervisor………………………………………………………………. Date ………………………………………………………………………………. Signature ………………………………………………………………………… 4 ACKNOWLEDGEMENT I would like to thank Management of International Health Sciences University for offering me the opportunity to do a Master of Science Degree in Public Health. Thanks again go to the Dean of the Institute of Health Policy and Management and entire staff body for their guidance during the course. Special thanks go to the supervisors Mr. Lony Titus and Mr. Afayo Robert for the input and professional guidance that enabled me to pursue the work with minimum difficulty. I would like to recognize the support of my parents and friends for all the financial, moral Support as well as encouragement given to me which made me go through this course successfully. Lastly, my appreciation goes to my classmates for the support and cooperation they rendered during the course. You are special to me. 5 TABLE OF CONTENTS DECLARATION..............................................................................................................................1 DEDICATION.................................................................................................................................2 APPROVAL...............................................................................................................................2 ACKNOWLEDGEMENT...............................................................................................................4 TABLE OF CONTENTS.................................................................................................................4 LIST OF TABLES...........................................................................................................................8 LIST OF FIGURES.........................................................................................................................9 LIST OF ACRONYMS..................................................................................................................10 ABSTRACT...................................................................................................................................11 OPERATIONAL DEFINITIONS..................................................................................................11 CHAPTER ONE............................................................................................................................12 INTRODUCTION.........................................................................................................................12 1.0 Introduction..............................................................................................................................12 1.1 Background to the study..........................................................................................................12 1.1.1 The role of community health workers.................................................................................12 1.1.2 The Training of Community Health Workers.......................................................................12 1.2 Background of the study area..................................................................................................12 1.3 Scope of the study....................................................................................................................13 1.4 Problem statement ...................................................................................................................13 1.5 Main objective.........................................................................................................................13 1.5.1 Specific objectives................................................................................................................13 1.6 Research questions...................................................................................................................13 1.7 Hypotheses...............................................................................................................................13 1.8 Significance of the Study.........................................................................................................14 1.9 Conceptual Framework............................................................................................................14 .................................................................................................................................................16 CHAPTER TWO...........................................................................................................................17 2.0 LITERATURE REVIEW.........................................................................................................17 6 2.1 Introduction..............................................................................................................................17 2.2 Community Health Workers in the World................................................................................17 2.3 Community health workers in Africa.......................................................................................17 2.4 Community Health Workers in Uganda...................................................................................17 2.5 Influence of socio demographics on performance of CHWs...................................................17 2.6 Influence of Availability of Supplies on performance of CHWs.............................................18 2.7 Influence of Motivation/incentives on performance of CHWs................................................18 2.8 Influence of Support supervision on performance of CHWs...................................................18 CHAPTER THREE.......................................................................................................................20 3.0 METHODOLOGY..................................................................................................................20 3.1 Introduction..............................................................................................................................20 3.2 Research design ......................................................................................................................20 3.3 Study Population (sample frame).............................................................................................20 3.4 Sampling procedure.................................................................................................................20 3.5 Sample size..............................................................................................................................20 3.6 Study variables and their indicators.........................................................................................21 3.7 Data collection tools................................................................................................................21 3.7.1 Questionnaires.......................................................................................................................21 3.8 Data Management....................................................................................................................21 3.8.1 Data Analysis........................................................................................................................21 3.9 Quality Control Measures.......................................................................................................21 3.10 Ethical Considerations...........................................................................................................21 CHAPTER FOUR..........................................................................................................................22 4.0 Results......................................................................................................................................22 4.1 Introduction..............................................................................................................................22 4.2 Demographic of respondents (CHWs: ∑=121)........................................................................22 4.3 Performance of CHWs in Mityana District.............................................................................22 4.3 .1 Percentage of CHWs As Regards Level of Performance.....................................................24 4.4 Bivariate Analysis of Influence of Availability of Supplies on Performance of CHWs..........24