Table 4

Programme management factors associated with attrition of CHWs in the Community Health Worker Attrition Study, Kwale County, Kenya

FactorUnivariate analysesMultivariate analyses
OR (95% CI)P valuesOR (95% CI)P values
Supervision last 1 month
 >3 times11
 None0.24 (0.10 to 0.60)0.13 (0.04 to 0.39)
 1 time0.17 (0.08 to 0.46)0.17 (0.06 to 0.48)
 2 times0.29 (0.11 to 0.71)0.27 (0.09 to 0.83)
 3 times1.04 (0.33 to 3.30)<0.0010.95 (0.24 to 3.72)<0.001
Refresher training (≤1)
 Yes11
 No4.26 (2.61 to 6.94)<0.0013.95 (2.20 to 7.10)<0.001
Feedback from supervisor
 Yes11
 No1.85 (1.11 to 3.07)0.021.99 (1.01 to 3.91)0.05
Received cash payments
 Yes11
 No0.76 (0.49 to 1.21)0.230.77 (0.44 to 1.35)0.37
Receive support to enhance
CHW work
 Yes11
 No1.36 (0.86 to 2.14)0.181.26 (0.71 to 2.25)0.43
Understand CHW roles
 Yes11
 No4.86 (0.88 to 26.93)0.072.96 (0.34 to 25.50)0.32
Performance ever evaluated
 Yes11
 No1.87 (1.02 to 3.46)0.041.75 (0.74 to 4.12)0.20
Constraints faced as CHW
 Lack of supplies11
 Lack of transport1.12 (0.54 to 2.36)0.86 (0.33 to 2.21)
 Lack of community support0.89 (0.43 to 1.84)0.93 (0.38 to 2.31)
 Financial constraints1.87 (0.89 to 3.91)2.13 (0.84 to 5.37)
 Others1.37 (0.58 to 5.44)0.151.27 (0.32 to 5.09)0.09
Households visited in the last
month
 >1611
 0–51.84 (0.89 to 3.78)2.54 (1.07 to 6.02)
 6–161.21 (0.73 to 1.99)0.231.44 (0.78 to 2.67)0.14
Peer association
membership
 Yes11
 No6.21 (2.13 to 18.07)<0.0015.26 (1.34 to 20.61)0.02
Supervisor
 CHEW1
 CHC members0.78 (0.49 to 1.27)
 Others1.52 (0.59 to 3.90)0.34
Feel supervision adequate
 Yes1
 No1.05 (0.66 to 1.66)0.85
Adequate support from supervisor
 Yes1
 No1.15 (0.72 to 1.86)0.55
Opinion on CHWs
 Volunteer entirely1
 Get salary1.13 (0.70 to 1.81)
 Get stipend+other allowances0.64 (0.31 to 1.32)0.31
Who should select CHWs
 Community1
 CHC, MOH, etc1.132 (076 to 2.31)0.32
Days worked/month
 0–51
 6–101.31 (0.77 to 2.21)
 >101.37 (0.77 to 2.43)0.45
Why became CHW
 To assist community1
 Other reasons1.14 (0.63 to 2.04)0.66
  • CHC, community health committee; CHEW, community health extension worker; CHW, community health worker; MOH, Ministry of Health.