Factors influencing the sustainability of a community health volunteer programme — A scoping review

Abstract

Background: Sustainability of any Community health worker programme is determined by several internal and external factors and is highly context and region specific. We aimed to identify factors that influence the sustainability of a community health volunteer programme across the globe. Methods: We conducted a scoping review using the Arksey and O’Malley framework. From four major databases, we extracted qualitative and quantitative peer-reviewed studies published in the English language, from January 2000 to March 2022, that reported on factors influencing sustainability of a community volunteer programme. We adopted a narrative synthesis form to report our findings. Results: Our search strategy yielded 1086 citations, of which 35 articles were finally included for the review after screening for eligibility. The studies included in our review reported an attrition rate ranging from 9 to 53%. The crucial factors that played a decisive role in sustainability included sociodemographic and sociocultural factors, trust, incentives, identity and recognition, sense of belonging, family support and other programme-related factors. Conclusion: Our study found that several complex personal and social factors affect the community health volunteers’ performance, thereby impacting the scaling up of a community volunteer programme. Efforts to address these factors would aid policy makers to successfully sustain a volunteership programme in resource-poor settings.

Exploring ethics in the implementation of the Community Health Worker programmes in India

“…He says adapting the training modules of ASHAs from the rural context to train ASHAs in the urban context would be unethical, as it would leave ASHAs in the urban context underprepared to perform their duties. Sathish Rajaa and Balasubramaniam Palanisamy present a scoping review of factors influencing the sustainability of community health volunteers [20]. Providing incentives, security, adequate family support, appropriate transport facilities, identity and recognition as a good health worker were factors that motivated the CHWs and ensured sustainability.…”