Department of Sociology, Forman Christian College University, Lahore, Pakistan.
Department of Psychology, Lahore College of Women University, Lahore, Pakistan.
Prim Health Care Res Dev. 2022 May 2;23:e27. doi: 10.1017/S1463423622000081.
This study aimed to (i) identify community health workers' (CHWs) perceived satisfaction for maternal and neonatal health services, with respect to (1) socio-demographic characteristics; (2) coronavirus preparedness; (3) coronavirus responsiveness; and (4) employee satisfaction and (ii) investigate the interplay among study variables to identify the role of direct effects and mediation.
Women CHWs are salient providers for maternal and neonatal services at the primary level, especially in conservative regions. Service delivery is a valuable indicator for mother and newborn wellbeing. There is need for empirical evidence to understand how CHWs may be supported in delivering maternal and neonatal health services during pandemics.
Bivariate regression was used to identify the lower odds for CHWs' perceived satisfaction for maternal and neonatal health services. In addition, structural equation modeling was used to investigate if coronavirus responsiveness and employee satisfaction as mediating variables influence the relationship between coronavirus preparedness and maternal and neonatal health services. Data were collected telephonically from 350 CHWs. The sample was representative of 35 districts of Punjab, which is the most populated province in the country.
We found thirty predictors with respect to coronavirus preparedness, coronavirus responsiveness and employee satisfaction which contribute to lower odds of satisfaction for maternal and neonatal health services. We also found that coronavirus preparedness has a direct effect on maternal and neonatal health service satisfaction (β = .242, P < .001) and an indirect effect on maternal health satisfaction (β = .242, P < .001) via the mediation of employee satisfaction. We conclude with four critical recommendations to support CHWs in delivering optimal services, comprising of education and training, operational support, public acceptance, and employee support and benefits. The findings are important for the planning of primary health services and governance support for CHWs and poor women clients in Pakistan and other developing countries.
本研究旨在：(i) 确定社区卫生工作者（CHWs）对孕产妇和新生儿健康服务的满意度，具体涉及：(1) 社会人口统计学特征；(2) 冠状病毒防范准备；(3) 冠状病毒应对响应；以及 (4) 员工满意度；(ii) 调查研究变量之间的相互作用，以确定直接效应和中介效应的作用。
在初级保健层面，女性 CHWs 是孕产妇和新生儿服务的重要提供者，特别是在保守地区。服务提供是母婴健康的重要指标。有必要通过实证研究来了解在大流行期间如何支持 CHWs 提供孕产妇和新生儿保健服务。
采用二变量回归来确定 CHWs 对孕产妇和新生儿健康服务满意度较低的可能性。此外，还采用结构方程模型来调查冠状病毒应对响应和员工满意度作为中介变量是否会影响冠状病毒防范准备与孕产妇和新生儿健康服务之间的关系。数据通过电话从 350 名 CHWs 中收集。该样本代表了该国人口最多的旁遮普省的 35 个区。
我们发现了 30 个预测因子，涉及冠状病毒防范准备、冠状病毒应对响应和员工满意度，这些因素降低了对孕产妇和新生儿健康服务的满意度。我们还发现，冠状病毒防范准备对孕产妇和新生儿健康服务满意度具有直接影响（β=0.242，P<0.001），并且通过员工满意度的中介作用对产妇健康满意度也具有间接影响（β=0.242，P<0.001）。我们总结了四项支持 CHWs 提供最佳服务的关键建议，包括教育和培训、运营支持、公众接受度以及员工支持和福利。这些发现对于规划初级卫生服务以及为巴基斯坦和其他发展中国家的 CHWs 和贫困妇女客户提供治理支持具有重要意义。
