TY - JOUR
T1 - Understanding incentive preferences of community health workers using discrete choice experiments
T2 - A multicountry protocol for Kenya, Uganda, Bangladesh and Haiti
AU - Agarwal, Smisha
AU - Anaba, Udochisom
AU - Abuya, Timothy
AU - Kintu, Richard
AU - Casseus, Alain
AU - Hossain, Sharif
AU - Obadha, Melvin
AU - Warren, Charlotte E.
N1 - Funding Information:
This study has been reviewed and approved by the Population Council’s Institutional Review Board (IRB) in New York, the AMREF-Health Africa Ethics and Scientific Review Committee in Kenya, Zanmi Lasante’s IRB (Haiti) and the Higher Degrees Research Ethics Committee at Makerere University College of Health Sciences in Uganda, and the Bangladesh Medical Research Council. Dissemination activities will include sharing of findings through policy briefs, workshops, online blogs in community fora and peer-reviewed journal articles. The research approach is inherently designed around the need for research uptake by policy-makers. Involvement in the research from the beginning is the overarching strategy for promoting research uptake. To ensure there is significant demand for the final study findings, we will debrief policy-makers and other health system stakeholders at pivotal points in the initial stages as well as at the end of the study. We will share non-technical summaries of research results with all the partners for dissemination including the study’s key partners in the MoH. If there is enough interest, appropriate dissemination will be conducted with policy-makers in half-day workshops and to facilitate translation of the research findings in national CHW agenda.
Funding Information:
Funding This study is funded by the Bill & Melinda Gates Foundation. The funding body has no role in the study design, data collection, analysis or interpretation of data.
Publisher Copyright:
© 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY. Published by BMJ.
PY - 2019/12/11
Y1 - 2019/12/11
N2 - Introduction There is a renewed global interest in improving community health worker (CHW) programmes. For CHW programmes to be effective, key intervention design factors which contribute to the performance of CHWs need to be identified. The recent WHO guidelines recommends the combination of financial and non-financial incentives to improve CHW performance. However, evidence gaps remain as to what package of incentives will improve their performance in different country contexts. This study aims to evaluate CHW incentive preferences to improve performance and retention which will strengthen CHW programmes and help governments leverage limited resources appropriately. Methods and analysis A discrete choice experiment (DCE) will be conducted with CHWs in Bangladesh, Haiti, Kenya and Uganda with different levels of maturity of CHWs programmes. This will be carried out in two phases. Phase 1 will involve preliminary qualitative research including focus group discussions (FGDs) and key informant interviews to develop the DCE design which will include attributes relevant to the CHW country settings. Phase 2 will involve a DCE survey with CHWs, presenting them with a series of job choices with varying attribute levels. An orthogonal design will be used to generate the choice sets for the surveys. The surveys will be administered in locally-appropriate languages to at least 150 CHWs from each of the cadres in each country. Conditional and mixed multinomial logit (MMNL) models will be used for the estimation of stated preferences. Ethics and dissemination This study has been reviewed and approved by the Population Council's Institutional Review Board in New York, and appropriate ethics review boards in Kenya, Uganda, Bangladesh and Haiti. The results of the study will be disseminated through in-country dissemination workshops, meetings with country-level stakeholders and policy working groups, print media, online blogs and peer-reviewed journals.
AB - Introduction There is a renewed global interest in improving community health worker (CHW) programmes. For CHW programmes to be effective, key intervention design factors which contribute to the performance of CHWs need to be identified. The recent WHO guidelines recommends the combination of financial and non-financial incentives to improve CHW performance. However, evidence gaps remain as to what package of incentives will improve their performance in different country contexts. This study aims to evaluate CHW incentive preferences to improve performance and retention which will strengthen CHW programmes and help governments leverage limited resources appropriately. Methods and analysis A discrete choice experiment (DCE) will be conducted with CHWs in Bangladesh, Haiti, Kenya and Uganda with different levels of maturity of CHWs programmes. This will be carried out in two phases. Phase 1 will involve preliminary qualitative research including focus group discussions (FGDs) and key informant interviews to develop the DCE design which will include attributes relevant to the CHW country settings. Phase 2 will involve a DCE survey with CHWs, presenting them with a series of job choices with varying attribute levels. An orthogonal design will be used to generate the choice sets for the surveys. The surveys will be administered in locally-appropriate languages to at least 150 CHWs from each of the cadres in each country. Conditional and mixed multinomial logit (MMNL) models will be used for the estimation of stated preferences. Ethics and dissemination This study has been reviewed and approved by the Population Council's Institutional Review Board in New York, and appropriate ethics review boards in Kenya, Uganda, Bangladesh and Haiti. The results of the study will be disseminated through in-country dissemination workshops, meetings with country-level stakeholders and policy working groups, print media, online blogs and peer-reviewed journals.
KW - community health systems
KW - community health workers
KW - discrete choice experiment
KW - incentives
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U2 - 10.1136/bmjopen-2019-033601
DO - 10.1136/bmjopen-2019-033601
M3 - Article
C2 - 31831550
AN - SCOPUS:85076389517
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 12
M1 - e033601
ER -