ArticleGlobal health, science and practice2021
Beyond Institutionalization: Planning for Sustained Investments in Training, Supervision, and Support of Community Health Worker Programs in Bangladesh.
Article in Global health, science and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- A systematic review of the types, workload, and supervision mechanism of community health workers: lessons learned for Indonesia.BMC primary care · 2024Pooled it
- Qualitative accounts of community health workers providing and shaping mental health support in climate-vulnerable communities in Bangladesh.Scientific reports · 2026Article
- Financial motivation models for community health workers in low- and middle-income countries: a scoping review.Global health action · 2025Article
- A knowledge, attitude and practice-based integrative literature review of community health worker training on stroke and cardiovascular diseases in low-and middle-income countries.BMC primary care · 2025Review
- How does community health feature in Global Financing Facility planning documents to support reproductive, maternal, newborn, child and adolescent health and nutrition (RMNAH-N)? insights from six francophone West African countries.Global health action · 2024Article
- Quality, Usability, and Trust Challenges to Effective Data Use in the Deployment and Use of the Bangladesh Nutrition Information System Dashboard: Qualitative Study.Journal of medical Internet research · 2024Article
- Acceptability and operational feasibility of community health worker-led home phototherapy treatment for neonatal hyperbilirubinemia in rural Bangladesh.BMC pediatrics · 2024Article
- Perspectives of community and facility stakeholders on community health workers in rural Malawi.African journal of primary health care & family medicine · 2024Article
- Sustaining village malaria worker programmes with expanded roles: Perspectives of communities, healthcare workers, policymakers, and implementers in Vietnam.PLOS global public health · 2024Article
- Exploring the motivations of female community health volunteers in primary healthcare provision in rural Nepal: A qualitative study.PLOS global public health · 2024Article
- Leveraging community health workers as vaccinators: a case study exploring the role of Malawi's Health Surveillance Assistants in delivering routine immunization services.Human resources for health · 2023Article
- Examining Roles, Support, and Experiences of Community Health Workers During the COVID-19 Pandemic in Bangladesh: A Mixed Methods Study.Global health, science and practice · 2022Article
- Motivation and Performance of Community Health Workers: Nothing New Under the Sun, and Yet….Global health, science and practice · 2021Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBangladesh has a long history of mature and institutionalized community health worker (CHW) programs in primary health care. However, there is a lot of variability in the performance of the CHW programs in Bangladesh, as well as challenges associated with retention of CHWs. This study describes the challenges for CHWs, which in turn affect their motivation and performance.
methodsThis study was conducted from December 2019 to January 2020 in 4 districts in Bangladesh: Cox's Bazar, Khulna, Rajshahi, and Sylhet. Twenty focus group discussions were conducted with 121 participants, including family welfare assistants (FWA), health assistants (HA), and their direct supervisors. Thirty in-depth interviews were conducted with upazila and district-level stakeholders. Data were analyzed using a thematic approach with a particular focus on CHW motivation, job satisfaction, and incentive preferences for improving morale and performance.
resultsSeveral nonmonetary and monetary factors affect CHWs' motivation, performance, and job satisfaction. Recognition by the community, availability of promotions and technical recognition, increased training opportunities, reduced workloads, identification as government employees, access to transportation, provision of working tools, and improvements in the workplace environment were identified as important nonmonetary incentives. CHWs also discussed the importance of sufficient salaries and allowances. DISCUSSION: Several factors impede the effectiveness of the CHW programs in Bangladesh. Changes to technical ranks and wages for the health care sector need to take a sector-wide lens to enable systematic calibration of wages for all health care workers. This study highlights that institutionalization of CHWs without adequate and sustained support for continued training, compensation, supervision, access to working tools, and recognition is insufficient to drive change. Identifying pragmatic strategies that can be supported through existing government budgets to address these factors is vital to sustaining the community health workforce in Bangladesh.
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