| Title |
A qualitative assessment of health extension workers’ relationships with the community and health sector in Ethiopia: opportunities for enhancing maternal health performance
|
|---|---|
| Published in |
Human Resources for Health, September 2015
|
| DOI | 10.1186/s12960-015-0077-4 |
| Pubmed ID | |
| Authors |
Maryse C. Kok, Aschenaki Z. Kea, Daniel G. Datiko, Jacqueline E.W. Broerse, Marjolein Dieleman, Miriam Taegtmeyer, Olivia Tulloch |
| Abstract |
Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors in both the community and health sector, in order to enhance HEW performance. This study aimed to understand how relationships between HEWs, the community and health sector were shaped, in order to inform policy on optimizing HEW performance in providing maternal health services. We conducted a qualitative study in six districts in the Sidama zone, which included focus group discussions (FGDs) with HEWs, women and men from the community and semi-structured interviews with HEWs; key informants working in programme management, health service delivery and supervision of HEWs; mothers; and traditional birth attendants. Respondents were asked about facilitators and barriers regarding HEWs' relationships with the community and health sector. Interviews and FGDs were recorded, transcribed, translated, coded and thematically analysed. HEWs were selected by their communities, which enhanced trust and engagement between them. Relationships were facilitated by programme design elements related to support, referral, supervision, training, monitoring and accountability. Trust, communication and dialogue and expectations influenced the strength of relationships. From the community side, the health development army supported HEWs in liaising with community members. From the health sector side, top-down supervision and inadequate training possibilities hampered relationships and demotivated HEWs. Health professionals, administrators, HEWs and communities occasionally met to monitor HEW and programme performance. Expectations from the community and health sector regarding HEWs' tasks sometimes differed, negatively affecting motivation and satisfaction of HEWs. HEWs' relationships with the community and health sector can be constrained as a result of inadequate support systems, lack of trust, communication and dialogue and differing expectations. Clearly defined roles at all levels and standardized support, monitoring and accountability, referral, supervision and training, which are executed regularly with clear communication lines, could improve dialogue and trust between HEWs and actors from the community and health sector. This is important to increase HEW performance and maximize the value of HEWs' unique position. |
X Demographics
The data shown below were collected from the profiles of 35 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 11 | 31% |
| United States | 4 | 11% |
| Switzerland | 2 | 6% |
| South Africa | 2 | 6% |
| Netherlands | 2 | 6% |
| Ethiopia | 1 | 3% |
| Unknown | 13 | 37% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 21 | 60% |
| Scientists | 7 | 20% |
| Practitioners (doctors, other healthcare professionals) | 6 | 17% |
| Science communicators (journalists, bloggers, editors) | 1 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 306 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Tanzania, United Republic of | 1 | <1% |
| Mozambique | 1 | <1% |
| Netherlands | 1 | <1% |
| South Africa | 1 | <1% |
| United Kingdom | 1 | <1% |
| Sierra Leone | 1 | <1% |
| Canada | 1 | <1% |
| Unknown | 299 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 62 | 20% |
| Researcher | 43 | 14% |
| Student > Ph. D. Student | 31 | 10% |
| Student > Postgraduate | 21 | 7% |
| Student > Doctoral Student | 15 | 5% |
| Other | 57 | 19% |
| Unknown | 77 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 66 | 22% |
| Nursing and Health Professions | 52 | 17% |
| Social Sciences | 45 | 15% |
| Business, Management and Accounting | 7 | 2% |
| Biochemistry, Genetics and Molecular Biology | 5 | 2% |
| Other | 45 | 15% |
| Unknown | 86 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 26. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 December 2016.
All research outputs
#1,479,779
of 25,374,917 outputs
Outputs from Human Resources for Health
#125
of 1,261 outputs
Outputs of similar age
#20,771
of 286,342 outputs
Outputs of similar age from Human Resources for Health
#4
of 25 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,261 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.3. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 286,342 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 25 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 84% of its contemporaries.