Assessment of community health workers incentives on maternal and newborn health services performance

LIST OF FIGURES

FIGURE PAGE

Figure 1: Conceptual Framework 10

LIST OF APPENDICES

APPENDIX PAGE

Appendix 1: Questionnaire 52

Appendix 2: Data Collection Letter 55

Appendix 3: Acceptance Collection Letter 56

Appendix 4: Geographical Map of Rwinkwavu District Hospital 57

Appendix 5: Map of Rwanda Showing Kayonza District where Located Rwinkwavu District Hospital in South 58

LIST OF ABREVIATION

CBHPP: Community Based Hygiene Promotion Program

CBNP: Community Based Nutrition Program

CHC: Community Hygiene Club

CHWs: Community Health Workers

DHS: Demography and Health Survey

HC: Health Center

ICCM: Community Case Management

IMCI: Integrated Management of Childhood Illnesses

KMC: Kangulo Mother Care

MCHIP: Maternal Child Health Integrated Program

MGDs: Millennium Development Goal

MMR: Maternal Mortality rate

MNHC: Maternal and New Borne Health Care

MOH: Ministry of Health

MUAC: Measurement Upper Arm Circumference

PBF: Performance Based Financing

RUTF: Ready to use Therapeutic Food

SAM: Severe and Acute Malnutrition

UNICEF: United the Nation of Child Fund

USAID: United States Agency of International development

WHO: World Health Organization

WFP: World Food Program

ABSTRACT

Denys NDANGURURA, School of Graduated Studies, Bugema University, July, 2015. Thesis title; «ASSESSMENT OF COMMUNITY HEALTH WORKERS INCENTIVES ON MATERNAL AND NEWBORN HEALTH SERVICES IN RWINKWAVU DISTRICT HOSPITAL, KAYONZA DISTRICT, RWAND''A.

Chief Supervisor: Sylvia Callender -Carter, Dr. PH

The study was carried out on assessment of Community Health Workers Incentives on Maternal and newborn health services performance. The sample size was 236 CHWs in charge of MNH distributed in eight health centers of Rwinkwavu district hospital catchment area. To determine the demographic characteristics of respondent, the researcher used descriptive statistics. It revealed that the majority of them 125(53.2%) are those in the age range of 36 to 50 years. All respondents are women that are why when you look at gender 236(100%) were women. The marital status shows that the married are the predominant among other represented by 168 (71.1%). The level of education the majority of respondents 151(64.0%) have is primary. Most of the CHWs in charge of MNH are agro-farmers 193(81.8%) distributed as cultivators 91(38.6%), farmers 55(23.3%) and the farmers-cultivators represented 47(19.9%). The level of CHWs incentives was showed a low mean and standard deviation (=1.75; SD = 0.82). The results on MNH services performance the study was showed a moderate mean and standard deviation of (= 3.04; SD = 1.26).

Logistic regression was used to establish influence of CHWs incentives on performance of them in MNH services. CHWs financial incentives to be high are about 3 times as likely to perform in maternal and newborn health services (P=0.012, (1.26-6.26),UR=2.808) however result indicate that being a member of CHWs cooperative is not a significant predictor of performance of CHWs in MNH services(P>0.05

The study recommends reviewing the system of CHWs performance based financing system on equal opportunity and strong monitoring and evaluation based on mentorship of CHWs cooperatives.