Retention and sustainability of community-based health volunteers' activities: A qualitative study in rural Northern Ghana

<div><p>Background</p><p>The shortage of formal health workers has led to the utilization of Community-Based Health Volunteers (CBHV) to provide health care services to people especially in rural and neglected communities. Community-based health volunteers have been effective partners in health care delivery at the community level for many years. The challenge is how to retain these volunteers and also sustain their activities. This study explored factors affecting retention and sustainability of community-based health volunteers’ activities in a rural setting in Northern Ghana.</p><p>Methods</p><p>This was a qualitative study comprising thirty-two in-depth interviews (IDIs) with health volunteers and health workers in-charge of health volunteers’ activities. Purposive sampling technique was used to select study participants for the interviews. The interviews were transcribed and coded into themes using Nvivo 10 software. The thematic analysis framework was used to analyze the data.</p><p>Results</p><p>Study participants reported that the desire to help community members, prestige and recognition as doctors in community mainly motivated them to work as health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected the work. They suggested that lack of these things discouraged them from working as health volunteers. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots, bicycles, awards to hard working volunteers are mechanisms that can help retain community-based health volunteers and also sustain their activities.</p><p>Conclusion</p><p>Providing means of transport and non-monetary incentives would help to retain community-based health volunteers and also sustain their activities at the community level.</p></div

Map of the Upper East and Northern regions of Ghana, showing selected districts of study.

Map of the Upper East and Northern regions of Ghana, showing selected districts of study.</p

Association between the free maternal health care policy and risk of perinatal mortality.

Association between the free maternal health care policy and risk of perinatal mortality.</p

Distribution of maternal characteristics between the ‘free’ maternal health policy and the no ‘free’ maternal health care policy groups.

Distribution of maternal characteristics between the ‘free’ maternal health policy and the no ‘free’ maternal health care policy groups.</p

Characteristics of pregnant women participants.

Characteristics of pregnant women participants.</p

Stillbirth and facility delivery output of the Upper East and Northern regions of Ghana.

Stillbirth and facility delivery output of the Upper East and Northern regions of Ghana.</p

Conceptual framework: Multifaceted factors moderating stillbirth and perinatal mortality.

Conceptual framework: Multifaceted factors moderating stillbirth and perinatal mortality.</p

Additional file 1: of Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana

Interview guide. (DOCX 35 kb

Facility deliveries versus Stillbirth in the Upper East and Northern Regions.

Facility deliveries versus Stillbirth in the Upper East and Northern Regions.</p

The proportion of stillbirths and perinatal mortality in 2008 and 2014.

The proportion of stillbirths and perinatal mortality in 2008 and 2014.</p