Table 2

Management characteristics in the Community Health Worker Attrition Study, Kwale County, Kenya

CharacteristicCommunity health workers who left (%)
n=112
Community health workers who remained active (%)
n=262
Total
n=374
Trained >4 weeks
 No105 (30.5)239 (69.5)344
 Yes6 (23.1)20 (76.9)26
Refresher training (≤1)
 No54 (51.4)51 (48.6)105
 Yes52 (19.9)209 (80.1)261
Supervision last 1 month
 None28 (26.7)77 (73.3)105
 1 time31 (21.8)111 (78.2)142
 2 times23 (29.5)55 (70.5)78
 3 times14 (60.9)9 (39.1)23
 >3 times15 (60.0)10 (39.1)25
Supervisor
 CHC members38 (25.7)110 (74.3)148
 CHEW61 (30.5)139 (69.5)200
 Others8 (40.0)12 (60.0)20
Feel supervision adequate
 No42 (30.2)97 (69.8)139
 Yes67 (29.3)162 (70.7)229
Feedback from supervisor
 No34 (40.0)51 (60.0)85
 Yes75 (26.6)208 (73.5)283
Adequate support from
supervisor
 No37 (31.4)81 (68.6)118
 Yes71 (28.3)180 (71.7)251
Received cash payments
 No53 (27.0)143 (73.0)196
 Yes58 (32.8)119 (67.2)177
Opinion on CHWs
 Volunteer entirely50 (30.3)115 (69.7)165
 Get salary49 (32.9)100 (67.1)149
 Get stipend+other
 allowances
12 (21.8)43 (78.2)55
Who should select CHWs
 Community87 (28.7)216 (71.3)303
 CHC, MOH, etc24 (34.8)45 (65.2)69
Community appreciate work
 No2 (50.0)2 (50.0)4
 Yes109 (29.6)259 (70.4)368
Peer association
membership
 No12 (70.6)5 (29.4)17
 Yes99 (27.9)256 (72.1)355
Receive support to enhance CHW work
 No56 (32.6)116 (67.4)172
 Yes50 (26.2)141 (73.8)191
Understand CHW roles
 No4 (66.7)2 (33.3)6
 Yes107 (29.2)260 (70.8)367
Performance ever evaluated
 No21 (42.0)29 (58.0)50
 Yes90 (27.9)233 (72.1)323
Days worked/month
 0–553 (26.8)145 (73.2)198
 6–1032 (32.3)67 (67.7)99
 >1025 (33.3)50 (66.7)75
Households visited last month
 0–515 (40.5)22 (59.5)37
 6–1534 (30.9)76 (69.1)110
 ≥1660 (27.0)162 (73.0)222
Forum/dialogues last month
 None23 (34.9)43 (65.2)66
 Only 114 (16.7)70 (83.3)84
 2–458 (32.8)119 (67.2)117
 ≥516 (35.6)29 (64.4)45
Clients referred last month
 None30 (31.9)64 (68.1)94
 Only 110 (23.3)33 (76.7)43
 2–547 (29.2)114 (70.8)161
 ≥622 (31.9)47 (68.1)69
Why became CHW
 To assist community89 (29.0)218 (71.0)307
 Other reasons*20 (31.8)43 (68.3)63
Constraints faced as CHW
 Lack of supplies15 (26.3)42 (73.7)57
 Lack of transport27 (28.7)67 (71.3)94
 Lack of community support29 (24.2)91 (75.8)120
 Financial constraints32 (40.0)48 (60.0)80
 Others7 (38.9)11 (61.1)18
  • *Encouraged by community or family, for recognition in the community, for salary/stipend/tokens and to advance a career in health.

  • CHC, community health committee; CHEW, community health extension worker; CHW, community health worker; MOH, Ministry of Health.