Compensating CHWs and
Perdiem as an Incentive
This an amount most of the time paid by partners to
strengthen the self motivation based on monthly home visits, daily
accompaniment and key maternal health activities, timely completion of a
monthly report form and participation at monthly training. This perdiem is
between10 to 20$ depending on performance of community health workers
qualitatively and quantitatively (MOH, Rwanda 2011).
Compensating CHWs has a number of important benefits for both
the health care program and the communities it serves. First payment for
meaningful work provides a needed income for those in resource limited
setting.
Secondly, compensating CHWs can strengthen their roles as an
essential member of the clinical team, thereby creating a stronger bridge
between the community to the clinic or hospital based setting. Third, payment
particularly when it is a fair wage and paid on time can serve as a source of
motivation for CHWs in performing their work reliably and effectively. Fourth,
payment can also increase the amount of time CHWs are available on a weekly
basis, can prevent turnover, and can promote program consistency.
Finally, investment in CHWs can potentially increase uptake in
medical services, promoting adherence to HIV and TB medication and resulting in
long term improved health outcomes in the community (MOH, Rwanda 2011).
Compensation structures will vary by country and
program. Find out whether there are labor regulations that affect compensation
in addition to any minimum or maximum wage requirements or other regulations,
when budgeting for the CHWs program. Some programs either choose to or are
mandated to cap salaries at the same level as those paid to schoolteachers or
other civil servants. In some contexts, CHWs are paid a baseline salary and are
then given an incentive bonus for each sick community member they see. In other
places, CHWs receive compensation through a cooperative, whose members pool
their funds to support it and equal control over its operation. Additionally
many systems involve performance based financing, in which CHWs receive
compensation following the completion of certain responsibilities such as
monthly home visits or the accurate collection of household data (MOH, Rwanda
2011).
CHWs who have a higher skill level, such as those that work
with patients with MDR/TB may receive a higher monthly salary compared with
CHWs who are responsible for more general outreach (MOH, Rwanda 2011).
In Haiti, women's health workers are compensated
more than the typical CHW due to the greater knowledge base necessary to carry
out their work. When planning a compensation structure, consider if and how
CHWs will be paid , whether or not they will receive bonuses, top - up, or
other financial incentives. If CHWs receive payment, determine how much they
will receive and the schedule of payment (Healthy villages 2002). Types of
payment may include: money for meals, transportation, income from the sales of
products, monthly stipend, monthly salary, performance based financing, cash
for task, access to membership in a cooperative (Healthy villages 2002).
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