Fitri Abdul Razak Muhammad Izmanuddin, Fauzi Fatimah Ahmad, Zulkefli Nor Afiah Mohd
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Iran J Public Health. 2024 Dec;53(12):2768-2778.
Community Health Volunteers (CHVs) are crucial in achieving universal health coverage and vital in public health activities, including the COMBI (Communication for Behavioral Impact) approach for dengue prevention and control and assessing the performance of COMBI CHVs are essential in evaluating the program effectiveness. We aimed to measure the level of performance and determine predictors of high-performance among COMBI CHVs in Kuala Lumpur and Putrajaya.
A cross-sectional study was conducted in 2023 among 285 COMBI CHVs from 5 health operational zones in Kuala Lumpur and Putrajaya. The CHVs were stratified proportionately, with 45.5% of respondents randomly selected from each stratum based on their zones. Self-administered questionnaires assessed their performance level and associated factors, including training, supervision, knowledge, motivation, and job satisfaction. Chi-square and Multiple Logistic Regression tests were used to determine the factors and predictors of high-performance COMBI CHVs.
The prevalence of high-performance COMBI CHVs was 59.3%, significantly associated with training factors (experience, duration, and adequacy of training), supervision factors (being supervised, supervision frequency, and encouragement from supervision), motivation and job satisfaction level. As for significant predictors, having at least one day of training (AOR=14.557), being supervised by medical personnel (AOR=4.997), having a high motivation level (AOR=5.538) and having a high job satisfaction level (AOR=4.562) were more likely to have a high-performance level.
Training duration, supervisor background, motivation and job satisfaction can contribute to high-performance levels among COMBI CHVs, which can applied in evidence-based policies and strategies for performance improvement and more effective community healthcare delivery.
社区卫生志愿者在实现全民健康覆盖方面至关重要，在公共卫生活动中也起着关键作用，包括用于登革热预防和控制的行为影响沟通（COMBI）方法，而评估COMBI社区卫生志愿者的表现对于评估该项目的有效性至关重要。我们旨在衡量吉隆坡和布城COMBI社区卫生志愿者的表现水平，并确定高绩效的预测因素。
2023年对吉隆坡和布城5个卫生运营区的285名COMBI社区卫生志愿者进行了横断面研究。社区卫生志愿者按比例分层，根据所在区域从每个阶层中随机抽取45.5%的受访者。自行填写的问卷评估了他们的表现水平及相关因素，包括培训、监督、知识、动机和工作满意度。采用卡方检验和多元逻辑回归检验来确定高绩效COMBI社区卫生志愿者的因素和预测因素。
高绩效COMBI社区卫生志愿者的患病率为59.3%，与培训因素（经验、时长和培训充分性）、监督因素（接受监督、监督频率和监督鼓励）、动机和工作满意度水平显著相关。至于显著预测因素，接受至少一天的培训（调整后比值比[AOR]=14.557）、由医务人员监督（AOR=4.997）、具有高动机水平（AOR=5.538）和具有高工作满意度水平（AOR=4.562）的人更有可能具有高绩效水平。
培训时长、监督者背景、动机和工作满意度可促成COMBI社区卫生志愿者的高绩效水平，这可应用于基于证据的绩效改进政策和策略以及更有效的社区医疗服务提供。
