'We pledge to improve the health of our entire community'
- Grant, Carolyn, Nawal, Dipty, Guntur, Sai Mala, Kumar, Manish, Chaudhuri, Indrajit, Galavotti, Christine, Mahapatra, Tanmay, Ranjan, Kunal, Kumar, Gangesh, Mohanty, Sunil, Alam, Mohammed Aftab, Das, Aritra, Jiwani, Safia
- Authors: Grant, Carolyn , Nawal, Dipty , Guntur, Sai Mala , Kumar, Manish , Chaudhuri, Indrajit , Galavotti, Christine , Mahapatra, Tanmay , Ranjan, Kunal , Kumar, Gangesh , Mohanty, Sunil , Alam, Mohammed Aftab , Das, Aritra , Jiwani, Safia
- Date: 2018
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/281179 , vital:55699 , xlink:href="https://doi.org/10.1371/journal.pone.0203265"
- Description: Background: Motivation is critical to health worker performance and work quality. In Bihar, India, frontline health workers provide essential health services for the state’s poorest citizens. Yet, there is a shortfall of motivated and skilled providers and a lack of coordination between two cadres of frontline health workers and their supervisors. CARE India developed an approach aimed at improving health workers’ performance by shifting work culture and strengthening teamwork and motivation. The intervention—“Team-Based Goals and Incentives”—supported health workers to work as teams towards collective goals and rewarded success with public recognition and non-financial incentives. Methods: Thirty months after initiating the intervention, 885 health workers and 98 supervisors completed an interviewer-administered questionnaire in 38 intervention and 38 control health sub-centers in one district. The questionnaire included measures of social cohesion, teamwork attitudes, self-efficacy, job satisfaction, teamwork behaviors, equitable service delivery, taking initiative, and supervisory support. We conducted bivariate analyses to examine the impact of the intervention on these psychosocial and behavioral outcomes. Results: Results show statistically significant differences across several measures between intervention and control frontline health workers, including improved teamwork (mean = 8.8 vs. 7.3), empowerment (8.5 vs. 7.4), job satisfaction (7.1 vs. 5.99) and equitable service delivery (6.7 vs. 4.99). While fewer significant differences were found for supervisors, they reported improved teamwork (8.4 vs. 5.3), and frontline health workers reported improved fulfillment of supervisory duties by their supervisors (8.9 vs. 7.6). Both frontline health workers and supervisors found public recognition and enhanced teamwork more motivating than the non-financial incentives. Conclusions: The Team-Based Goals and Incentives model reinforces intrinsic motivation and supports improvements in the teamwork, motivation, and performance of health workers. It offers an approach to practitioners and governments for improving the work environment in a resource-constrained setting and where there are multiple cadres of health workers.
- Full Text:
- Date Issued: 2018
- Authors: Grant, Carolyn , Nawal, Dipty , Guntur, Sai Mala , Kumar, Manish , Chaudhuri, Indrajit , Galavotti, Christine , Mahapatra, Tanmay , Ranjan, Kunal , Kumar, Gangesh , Mohanty, Sunil , Alam, Mohammed Aftab , Das, Aritra , Jiwani, Safia
- Date: 2018
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/281179 , vital:55699 , xlink:href="https://doi.org/10.1371/journal.pone.0203265"
- Description: Background: Motivation is critical to health worker performance and work quality. In Bihar, India, frontline health workers provide essential health services for the state’s poorest citizens. Yet, there is a shortfall of motivated and skilled providers and a lack of coordination between two cadres of frontline health workers and their supervisors. CARE India developed an approach aimed at improving health workers’ performance by shifting work culture and strengthening teamwork and motivation. The intervention—“Team-Based Goals and Incentives”—supported health workers to work as teams towards collective goals and rewarded success with public recognition and non-financial incentives. Methods: Thirty months after initiating the intervention, 885 health workers and 98 supervisors completed an interviewer-administered questionnaire in 38 intervention and 38 control health sub-centers in one district. The questionnaire included measures of social cohesion, teamwork attitudes, self-efficacy, job satisfaction, teamwork behaviors, equitable service delivery, taking initiative, and supervisory support. We conducted bivariate analyses to examine the impact of the intervention on these psychosocial and behavioral outcomes. Results: Results show statistically significant differences across several measures between intervention and control frontline health workers, including improved teamwork (mean = 8.8 vs. 7.3), empowerment (8.5 vs. 7.4), job satisfaction (7.1 vs. 5.99) and equitable service delivery (6.7 vs. 4.99). While fewer significant differences were found for supervisors, they reported improved teamwork (8.4 vs. 5.3), and frontline health workers reported improved fulfillment of supervisory duties by their supervisors (8.9 vs. 7.6). Both frontline health workers and supervisors found public recognition and enhanced teamwork more motivating than the non-financial incentives. Conclusions: The Team-Based Goals and Incentives model reinforces intrinsic motivation and supports improvements in the teamwork, motivation, and performance of health workers. It offers an approach to practitioners and governments for improving the work environment in a resource-constrained setting and where there are multiple cadres of health workers.
- Full Text:
- Date Issued: 2018
Women's and health workers’ Voices in open, inclusive communities and effective spaces (VOICES)
- Kuhlmann, Serbert, Gullo, Sara, Galavotti, Christine, Grant, Carolyn, Cavatore, Maria, Posnock, Samuel
- Authors: Kuhlmann, Serbert , Gullo, Sara , Galavotti, Christine , Grant, Carolyn , Cavatore, Maria , Posnock, Samuel
- Date: 2017
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/281190 , vital:55700 , xlink:href="https://doi.org/10.1111/dpr.12209"
- Description: Given the growing popularity of the social accountability approach to governance, we developed and tested measures of governance outcomes to evaluate maternal and reproductive health social accountability interventions. We articulate a theory of change for how CARE's Community Score Card©, a social accountability approach, 1) empowers women, 2) empowers health workers and 3) creates expanded, inclusive and effective spaces for the two to interact. Our measures worked well in surveys of women and health workers. For women, eight of 13 scales had alphas ≥.70. For health workers, five of 11 scales were ≥.70; four were .60–.69. To our knowledge, this is the first attempt to develop comprehensive measures of governance outcomes to evaluate a social accountability approach for maternal and reproductive health.
- Full Text:
- Date Issued: 2017
- Authors: Kuhlmann, Serbert , Gullo, Sara , Galavotti, Christine , Grant, Carolyn , Cavatore, Maria , Posnock, Samuel
- Date: 2017
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/281190 , vital:55700 , xlink:href="https://doi.org/10.1111/dpr.12209"
- Description: Given the growing popularity of the social accountability approach to governance, we developed and tested measures of governance outcomes to evaluate maternal and reproductive health social accountability interventions. We articulate a theory of change for how CARE's Community Score Card©, a social accountability approach, 1) empowers women, 2) empowers health workers and 3) creates expanded, inclusive and effective spaces for the two to interact. Our measures worked well in surveys of women and health workers. For women, eight of 13 scales had alphas ≥.70. For health workers, five of 11 scales were ≥.70; four were .60–.69. To our knowledge, this is the first attempt to develop comprehensive measures of governance outcomes to evaluate a social accountability approach for maternal and reproductive health.
- Full Text:
- Date Issued: 2017
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