Factors associated with child health service delivery by female community health volunteers in Nepal: Findings from a national survey

Abstract

Background: Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been a lot of documented studies and reports, rarely has been explored the status and factors associated with the child health service provided by these volunteers. The aim of this study was to identify the factors associated with the child health service delivery by FCHVs.Methods : A national survey was conducted in 2014 in Nepal that included 4,302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. The data was extracted and the association of child health services with characteristics was examined using Chi-square test (χ2) followed by logistic regression. Results: Overall, 62.6% of FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted health mothers’ group meeting, involved in local committees and those who supported antenatal care and outreach clinics related activities had higher odds of providing child health services. Similarly, FCHVs equipped with the stock of Cotrimoxazole tablet, Zinc tablet, Oral Rehydration Salt packets were more likely to provide child health services. The province-wise analysis showed that FCHVs from Province 5 and Sudur Paschim Province were more likely to provide child health services compared to their counterparts from province 1. Technology-wise, FCHVs who were using mobile were more likely to provide child health services.Conclusions : FCHVs are important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs, availability of key commodities, involvement of FCHVs in regular health mothers’ group meeting, use of mobile phone, involvement in other public health programs and social networks, and utilization of the FCHV fund need to be taken into consideration.

Engaging female community health volunteers in maternal health services and its satisfaction among village mothers in Hill and Mountain Regions, Nepal

“…Furthermore, as prior studies [10] , [14] , [15] stated, it was clear that the monthly meeting of FCHVs leads to improved knowledge of maternal health among village mothers. Also, it was identified that FCHVs used to visit the pregnant woman's home to inform them of ANC education and check their condition [20] . The statement adds weight to dispersing the debates in the literature, arguing lake of care during pregnancy or childbirth [26] .…”

“…Additionally, evidence showed that villagers have developed trust with FCHVs over time by their selfless volunteering of maternal services such as home visiting or door-to-door visits [19] . In addition, they notice the danger signs including the vaginal bleeding and heavy pain, severe headaches and trouble breathing in postpartum women and new-borns during postnatal home visits and they can advise the new mother how to take care of the baby [20] .…”