Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya.
Health Policy. 2010 Oct;97(2-3):232-7. doi: 10.1016/j.healthpol.2010.05.004. Epub 2010 Jun 8.
This paper examines trends and underlying causes of attrition among volunteer community health workers in home-based care for people living with HIV and AIDS in western Kenya.
Ethnographic data were collected between January and November 2006 through participant observation, focus group discussions and in-depth interviews with 30 CHWs, NGO staff and health care providers and 70 PLWHA.
An attrition rate of 33% was observed among the CHWs. The reasons for dropout included: the cultural environment within which CHWs operated; lack of adequate support from area NGOs; poor selection criteria for CHWs; and power differences between NGO officials and CHWs which fostered lack of transparency in the NGOs' operations.
In order to achieve well functioning and sustainable HBC services, factors which influence retention/dropout of CHWs should be addressed taking into account the socio-cultural, programmatic and economic contexts within which CHW activities are implemented.
本文旨在探讨在肯尼亚西部，针对艾滋病毒/艾滋病患者的家庭护理中，志愿社区卫生工作者流失的趋势及其根本原因。
2006 年 1 月至 11 月期间，采用参与式观察、焦点小组讨论和深入访谈的方法，对 30 名社区卫生工作者、非政府组织工作人员和医疗保健提供者以及 70 名艾滋病毒感染者/艾滋病患者进行了调查，收集了人种学数据。
社区卫生工作者的流失率为 33%。离职原因包括：社区卫生工作者工作所在的文化环境；地区非政府组织提供的支持不足；社区卫生工作者选拔标准较差；非政府组织官员与社区卫生工作者之间的权力差异，导致非政府组织运作缺乏透明度。
为了实现运作良好且可持续的家庭护理服务，应考虑到社区卫生工作者活动实施的社会文化、计划和经济背景，解决影响社区卫生工作者留任/离职的因素。
