University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne School of Population and Global Health
  • Melbourne School of Population and Global Health - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne School of Population and Global Health
  • Melbourne School of Population and Global Health - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Community Health Workers as Influential Health System Actors and not "Just Another Pair Of Hands".

    Thumbnail
    Citations
    Altmetric
    Author
    Kane, S; Radkar, A; Gadgil, M; McPake, B
    Date
    2020-04-27
    Source Title
    International Journal of Health Policy and Management
    Publisher
    Maad Rayan Publishing Company
    University of Melbourne Author/s
    McPake, Barbara; Kane, Sumit Shrikant
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Kane, S., Radkar, A., Gadgil, M. & McPake, B. (2020). Community Health Workers as Influential Health System Actors and not "Just Another Pair Of Hands".. Int J Health Policy Manag, https://doi.org/10.34172/ijhpm.2020.58.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254233
    DOI
    10.34172/ijhpm.2020.58
    Open Access URL
    http://doi.org/10.34172/ijhpm.2020.58
    Abstract
    BACKGROUND: Over the last 20 years, community health workers (CHWs) have become a mainstay of human resources for health in many low- and middle-income countries (LMICs). A large body of research chronicles CHWs' experience of their work. In this study we focus on 2 narratives that stand out in the literature. The first is the idea that social, economic and health system contexts intersect to undermine CHWs' experience of their work, and that a key factor underpinning this experience is that LMIC health systems tend to view CHWs as just an 'extra pair of hands' to be called upon to provide 'technical fixes.' In this study we show the dynamic and evolving nature of CHW programmes and CHW identities and the need, therefore, for new understandings. METHODS: A qualitative case study was carried out of the Indian CHW program (CHWs are called accredited social health activists: ASHAs). It aimed to answer the research question: How do ASHAs experience being CHWs, and what shapes their experience and performance? In depth interviews were conducted with 32 purposively selected ASHAs and key informants. Analysis was focused on interpreting and on developing analytical accounts of ASHAs' experiences of being CHWs; it was iterative and occurred throughout the research. Interviews were transcribed verbatim and transcripts were analysed using a framework approach (with Nvivo 11). RESULTS: CHWs resent being treated as just another pair of hands at the beck and call of formal health workers. The experience of being a CHW is evolving, and many are accumulating substantial social capital over time - emerging as influential social actors in the communities they serve. CHWs are covertly and overtly acting to subvert the structural forces that undermine their performance and work experience. CONCLUSION: CHWs have the potential to be influential actors in the communities they serve and in frontline health services. Health systems and health researchers need to be cognizant of and consciously engage with this emerging global social dynamic around CHWs. Such an approach can help guide the development of optimal strategies to support CHWs to fulfil their role in achieving health and social development goals.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [45770]
    • Melbourne School of Population and Global Health - Research Publications [4369]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors