The study was conducted to analyze the kind and extent of participation of community health workers (CHWs) in community Maternal and Child Health Care (MCHC), the factors that may explain such participation, and the link of such participation to the community maternal and child health (MCH) level. It also sought to determine the problems encountered by the health workers in participating in the MCHC activities and their suggestions to solve these problems.
The study involved 282 CHWs in District I, Nueva Ecija chosen through proportional stratified random sampling. Primary data were gathered through personal agency reports and records. The data were analyzed using descriptive and inferential statistics.
The CHWs were generally female, married, middle age, and high school graduates. The average household size was 4.47 members, slightly lower than the national average. Agriculture was the primary source of family income. The average gross annual family income was Php51,000. The mean per capita income was Php11,668 per year, slightly lower than the regional and national marks. Most of the CHWs were affiliated to one to two community organizations, which allowed them to socialize and exchange know-low with other community residents. They has attended one or two trainings, which primarily focused on basic health care and conducted mainly by the MHO and sometimes by the PHO and other training institutions, both public and private.
The CHWs have a highly favorable attitude towards the MCHC activities, showed high motivation in their activities, and high community attachment. They considered the leadership style of their MHO supervisor as participative, their relationship with their MHO supervisor and fellow CHWs as highly satisfactory, and their health work incentives as moderately satisfactory. They viewed their community as being able to highly meet its basic survival and enabling needs, and moderately its security and infrastructure needs. They found the community leaders as moderately supportive of the MCHC activities and the community members as moderately responsive to the health activities.
The CHWs showed high participation in the planning, implementation, and monitoring and evaluation phases of the MCHC activities. Moreover, they viewed their communities as being able to highly meet the basic MCH needs, thus, attain a relatively high MCH level.
Results of the correlation test, particularly the Pearson r, showed that except for community attachment, all the independent variables considered in the study were associated with CHWs’ kind and extent of participation in the MCHC activities. More specifically, attitude towards the MCHC activities, motivation, leadership style, leader-members’ and members’ relationships, incentives, level of community development, community leadership’s supportiveness, and community members’ responsiveness were significantly related to CHWs participation in the health activities. The stepwise regression analysis results showed that attitude, motivation, attachment to the community, leadership style, leader-members’ and members’ relationships, level of community development and community leadership’s supportiveness variedly but significantly predicted CHWs’ participation. Ultimately, based on Pearson r results, CHWs’ kind and extent of participation in the MCHC activities was significantly correlated with the community MCH level.
The predominant problems encountered by the CHWs in participating in the MCHC activities were the pressure of allocating their time between family concerns and health activities and their inadequate skills in data analysis, reporting, and fund sourcing. The other prevalent problems of the health volunteers were their inadequate work resources, incentives and training as well as the inadequate support to community leaders and readiness of members to sustain health initiatives. To address these problems, the CHWs primarily suggested the following: communication and coordination between CHWs and MHO personnel and among CHWs, regarding tooling of CHWs, fund sourcing and networking by MHO head and local leaders and continuing communication-education-advocacy campaign.
