ArticleHuman resources for health2020
Measuring motivation among close-to-community health workers: developing the CTC Provider Motivational Indicator Scale across six countries.
Article in Human resources for health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- A systematic review of participatory approaches to empower health workers in low- and middle-income countries, highlighting Health Workers for Change.International health · 2023Pooled it
- The Locus-of-Hope Enhancement Program for Filipino Community Health Workers' Hope and Well-Being: A Parallel Randomized Alternative-Treatments Study.Journal of community psychology · 2026Trial
- Prison-based HIV partner notification in Indonesia: rationale and design of a hybrid type 1 effectiveness-implementation study.BMC public health · 2026Trial
- Multidimensional performance enablers of Ethiopian community-based health extension program: A scoping review.PloS one · 2025Article
- Effects of financial compensation structures on community health worker performance, motivation, and retention: evidence from a multi-arm quasi-experiment in Uganda.Frontiers in health services · 2025Article
- An anthropological history of Nepal's Female Community Health Volunteer program: gender, policy, and social change.International journal for equity in health · 2024Article
- Article
- [A Rare Case of Extremely High Counts of EpCAMSichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022Article
- Community health workers at the dawn of a new era: 10. Programme performance and its assessment.Health research policy and systems · 2021Review
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Authors and funding
12 authors at 10 institutions in 9 countries.
Funding
Abstract
backgroundClose-to-community (CTC) health service providers are a cost-effective and important resource in the promotion of and increasing access to health services. However, many CTC provider programmes suffer from high rates of de-motivation and attrition due to inadequate support systems. Recent literature has identified the lack of rigorous approaches towards measuring and monitoring motivation among CTC providers as an important gap. Building on scales used in previous studies, we set out to develop a short, simple-to-administer scale to monitor and measure indicators of CTC provider motivation across CTC programmes implemented in six countries: Ethiopia, Kenya, Malawi, Mozambique, Indonesia, and Bangladesh.
methodsWe used focus group discussions (n = 18) and interviews (n = 106) conducted with CTC providers across all six countries, applying thematic analysis techniques to identify key determinants of motivation across these contexts. These themes were then used to carry out a systematic search of the literature, to identify existing scales or questionnaires developed for the measurement of these themes. A composite 24-item scale was then administered to CTC providers (n = 695) across the six countries. Survey responses were subsequently randomly assigned to one of two datasets: the first for scale refinement, using exploratory techniques, and the second for factorial validation. Confirmatory factor analysis was applied to both datasets.
resultsResults suggest a 12-item, four-factor structure, measuring community commitment, organisational commitment, job satisfaction, and work conscientiousness as common indicators of motivation among CTC providers across the six countries.
conclusionsConsistent with previous studies, findings support the inclusion of job satisfaction, organisational commitment, and work conscientiousness within the CTC Provider Motivation Indicator Scale. In addition, findings further supported the addition of a fourth, community commitment, sub-scale. Practical applications of the revised scale, including how it can be applied to monitor motivation levels within CTC provider programming, are discussed.
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