Evidence map›Paper›PMID 36270659›Full record

ArticleBMJ global health2022

It is not all about salary: a discrete-choice experiment to determine community health workers' motivation for work in Nigeria.

Whenayon Simeon Ajisegiri, David Peiris, Seye Abimbola, Olumuyiwa O Odusanya, Azeb Gebresilassie Tesema, Rohina Joshi, Blake Angell

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 4 countries.

Whenayon Simeon AjisegiriThe George Institute for Global Health, Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia wajisegiri@georgeinstitute.org.au.ORCID 0000-0002-8081-7058
David PeirisThe George Institute for Global Health, Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia.ORCID 0000-0002-6898-3870
Seye AbimbolaSchool of Public Health, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Olumuyiwa O OdusanyaDepartment of Community Health and Primary Health Care, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.
Azeb Gebresilassie TesemaThe George Institute for Global Health, Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia.
Rohina Joshi *School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Blake Angell *The George Institute for Global Health, Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia.ORCID 0000-0002-7188-7740
UNSW Sydney · AULagos State University · NGThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCommunity health workers (CHWs) constitute the majority of primary healthcare (PHC) workers in Nigeria, yet little is understood about their motivations or the most effective interventions to meet their needs to ensure quality health coverage across the country. We aimed to identify factors that would motivate CHWs for quality service delivery.

methodsA discrete-choice experiment was conducted among 300 CHWs across 44 PHC facilities in the Federal Capital Territory, Abuja Nigeria. Based on the literature review and qualitative research, five attributes, namely: salary, educational opportunities, career progression and in-service training, housing and transportation, were included in the experiment. CHWs were presented with 12 unlabelled choice sets, using tablet devices, and asked to choose which of two hypothetical jobs they would accept if offered to them, or whether they would take neither job. Mixed multinomial logistic models were used to estimate stated preferences for the attributes and the likely uptake of jobs under different policy packages was simulated.

resultsAbout 70% of the respondents were women and 39% worked as volunteers. Jobs that offered career progression were the strongest motivators among the formally employed CHWs (β=0.33) while the 'opportunity to convert from CHW to another cadre of health workers, such as nursing' was the most important motivator among the volunteers' CHWs (β=0.53). CHWs also strongly preferred jobs that would offer educational opportunities, including scholarship (β=0.31) and provision of transport allowances (β=0.26). Policy scenario modelling predicted combined educational opportunities, career progression opportunities and an additional 10% of salary as incentives was the employment package that would be most appealing to CHWs.

conclusionCHWs are motivated by a mix of non-financial and financial incentives. Policy interventions that would improve motivation should be adequate to address various contexts facing different CHWs and be flexible enough to meet their differing needs.

Indexed as

Community Health WorkersMotivationAttitude of Health PersonnelFemaleHumansMaleNigeriaSalaries and Fringe BenefitsHealth policyHealth services researchHealth systems

Identifiers

PMID36270659
PMCPMC9594556
OpenAlexW4307168972

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.