Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Findings by Burgard, Kalousova, and Seefeldt on the mental health impact of job insecurity

ISR ranks 4th in UM's record-setting unit expenditures for research

Frey on why Michigan needs more newcomers

More News

Highlights

On Giving Blue Day, help support the next generation through the PSC Alumni Grad Student Support Fund or ISR's Next Gen Fund

Bailey et al. find higher income among children whose parents had access to federal family planning programs in the 1960s and 70s

U-M's campus climate survey results discussed in CHE story

U-M honors James Jackson's groundbreaking work on how race impacts the health of black Americans

More Highlights

Next Brown Bag

Mon, Jan 22, 2018, noon: Narayan Sastry

Factors Shaping Interactions Among Community Health Workers in Rural Ethiopia: Rethinking Workplace Trust and Teamwork

Publication Abstract

Dynes, Michelle M., Rob Stephenson, Craig Hadley, and Lynn M. Sibley. 2014. "Factors Shaping Interactions Among Community Health Workers in Rural Ethiopia: Rethinking Workplace Trust and Teamwork." Journal of Midwifery and Women's Health, 59(s1): S32-S43.

Introduction Worldwide, a shortage of skilled health workers has prompted a shift toward community-based health workers taking on greater responsibility in the provision of select maternal and newborn health services. Research in mid- and high-income settings suggests that coworker collaboration increases productivity and performance. A major gap in this research, however, is the exploration of factors that influence teamwork among diverse community health worker cadres in rural, low-resource settings. The purpose of this study is to examine how sociodemographic and structural factors shape teamwork among community-based maternal and newborn health workers in Ethiopia.

Methods A cross-sectional survey was conducted with health extension workers, community health development agents, and traditional birth attendants in 3 districts of the West Gojam Zone in the Amhara region of Ethiopia. Communities were randomly selected from Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) sites; health worker participants were recruited using a snowball sampling strategy. Fractional logit modeling and average marginal effects analyses were carried out to identify the influential factors for frequency of work interactions with each cadre.

Results One hundred and ninety-four health workers participated in the study. A core set of factors—trust in coworkers, gender, and cadre—were influential for teamwork across groups. Greater geographic distance and perception of self-interested motivations were barriers to interactions with health extension workers, while greater food insecurity (a proxy for wealth) was associated with increased interactions with traditional birth attendants.

Discussion Interventions that promote trust and gender sensitivity and improve perceptions of health worker motivations may help bridge the gap in health services delivery between low- and high-resource settings. Inter-cadre training may be one mechanism to increase trust and respect among diverse health workers, thereby increasing collaboration. Large-scale, longitudinal research is needed to understand how changes in trust, gender norms, and perceptions of motivations influence teamwork over time.

DOI:10.1111/jmwh.12135 (Full Text)

Country of focus: Ethiopia.

Browse | Search : All Pubs | Next