CHWs' Challenges and Job Satisfaction

WHO consider "Community health workers should be members of the communities where they work, should be selected by the communities, should be answerable to the communities' needs and priorities, should be supported by the health system but not necessarily a part of the government and have shorter training than professional health workforce". CHWs aims to provide appropriate, accessible care and bring care closer to mothers and babies, bridging the service delivery gap in underserved communities. CHWs can effectively provide key primary, maternal, and newborn health care services including immunizations, tuberculosis treatment and contraceptive counseling. CHWs face several challenges in reaching their full potential. Many of the obstacle's stem from a lack of understanding about their role within primary health system. CHWs are faced by community and familial expectations of selflessness, equitably applied care, maintaining domestic responsibilities at home and implied understanding that extra work did not amount to extra pay. In addition, motivation and satisfaction are key not only for retention but also for performance. Better workforce performance is positively associated with higher job satisfaction, and low levels of job satisfaction adversely affect employee commitment and sequentially affect achievement of organizational objectives and performance. Factors strongly associated with CHW satisfaction include relationships with health workers and communities, the availability of job aides and the capacity to provide services and with the training. On the other hand, CHWs were highly dissatisfied with the unavailability of transportation for carrying out their tasks and the lack of allowances or financial incentives. Also, Non-financial incentives include community recognition and respect, acquisition of valued skills, personal growth and development, accomplishment, peer support and community factors like relations with communities and leaders. Other supportive CHW programmed factors. include frequent supervision and continuous training. therefore, CHW interventions must be implemented with an understanding of the complex challenges faced by CHWs and community members. This would in turn empower CHWs in navigating complex relationships within the community and the health system.