Unlocking Success: Determining Predictors of High-Performance among COMBI Community Health Volunteers in Kuala Lumpur and Putrajaya
,
Abstract
Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
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18. Sondaram NK, Kadir SH, Manaf RA (2018). Factors associated with knowledge of healthy community, empowers nation (KOSPEN) and its implementation among community health volunteers in Kulim District, 2017. Malaysian J Med Health Sci, 14 (2): 7–16.
19. Sophia M, Khairi M, Aisyah S, et al (2021). Knowledge, attitude and practice on dengue fever prevention among com-munities in Mutiara Ville, Cyberjaya. Mal J Med Health Sci, 17(SUPP11): 95-104.
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22. Olalere AB (2013). Effect of motivation on job performance by community devel-opment workers in Osun State, Nigeria. Int J Community Dev, 1 (2): 48-57.
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25. Hosmer DW, Lemeshow S (2013). Applied logistic regression. 3rd ed. Hoboken, New Jersey: John Wiley & Sons.
26. Alam K, Tasneem S, Oliveras E (2012). Re-tention of female volunteer community health workers in Dhaka urban slums: a case-control study. Health Policy Plan, 27 (6): 477–86.
27. Kok M, Dieleman M, Taegtmeyer M, et al (2015). Which intervention design fac-tors influence performance of commu-nity health workers in low- and middle-income countries? a systematic review. Health Policy Plan, 30(9): 1207–27.
28. Sarma H, Jabeen I, Luies SK, et al (2020). Performance of volunteer community health workers in implementing home-fortification interventions in Bangla-desh: a qualitative investigation. PLoS One, 15 (4):e0230709.
29. Department of Statistics Malaysia (2022). Current population estimates Malaysia 2022. https://www.dosm.gov.my/portal-main/release-content/current-population-estimates-malaysia-2022
30. Ahmad Fahmy WF, Haron N, Lim SC, et al (2022). Building the capacity of commu-nity health volunteers for non-communicable disease prevention in low-income urban communities in Ma-laysia. J Glob Health Rep, 6: e2022042.
31. Kuule Y, Dobson AE, Woldeyohannes D, et al (2017). Community health volun-teers in primary healthcare in rural Uganda: factors influencing perfor-mance. Front Public Health, 5: 62.
32. Department of Statistics Malaysia (2022). Key findings population and housing census of Malaysia 2020 report. https://www.mycensus.gov.my/index.php/census-product/publication/175-census-2020/1816-key-findings-of-census-2020
33. Kawakatsu Y, Sugishita T, Tsutsui J, et al (2015). Individual and contextual factors associated with community health work-ers’ performance in Nyanza Province, Kenya: a multilevel analysis. BMC Health Serv Res, 15:442.
34. Mostafa H, Lim Y (2020). Examining the re-lationship between motivations and re-silience in different international stu-dent groups attending U.S. universities. J Int Stud, 10 (2): 306–19.
35. Resnick B (2018). The relationship between resilience and motivation. In: Resilience in Aging. Springer, Cham, p. 221–44.
36. Woolfolk A (2019). Educational Psychology. 14th ed. Pearson Education.
37. Snelgar R, Shelton SA, Giesser A (2017). A comparison of South African and Ger-man extrinsic and intrinsic motivation. South African Journal of Economic and Man-agement Sciences, 20 (1): e1552.
38. Fatehi B, Karimi A, Pour EG, et al (2015). Impact of quality of work life on job satisfaction. Int J Sport Stud, 5 (1): 79–86.
39. Inayat W, Jahanzeb Khan M (2021). A study of job satisfaction and its effect on the performance of employees working in private sector organizations, Peshawar. Educ Res Int, 2021 (1):1-9.
40. Wang H, Jin Y, Wang D, et al (2020). Job satisfaction, burnout, and turnover inten-tion among primary care providers in rural China: results from structural equa-tion modeling. BMC Fam Pract, 21 (1): 12.
2. World Health Organization (2008). Revisit-ing community-based health workers and community health volunteers. WHO Regional Office for South-East Asia. https://iris.who.int/handle/10665/206334
3. Acharya D, Singh JK, Adhikari S, Jain V (2016). Association between sociodemo-graphic characteristics of female com-munity health volunteers and their knowledge and performance on mater-nal and child health services in rural Nepal. J Multidiscip Healthc, 9: 111–20.
4. Vareilles G, Marchal B, Kane S, et al (2015). Understanding the motivation and per-formance of community health volun-teers involved in the delivery of health programmes in Kampala, Uganda: a re-alist evaluation. BMJ Open, 5 (11):e008614.
5. Ogutu M, Muraya K, Mockler D, Darker C (2021). Factors influencing the perfor-mance of community health volunteers working within urban informal settle-ments in low- and middle-income coun-tries: a qualitative meta-synthesis review. Hum Resour Health, 19 (1): 144.
6. Taguchi A, Murayama H, Ono K (2021). As-sociation between Japanese community health workers’ willingness to continue service and two categories of motives: altruistic and self-oriented. PLoS One, 16 (10): e0220277.
7. Rather IA, Parray HA, Lone JB, et al (2017). Prevention and control strategies to counter dengue virus infection. Front Cell Infect Microbiol, 7:336.
8. Ministry of Health Malaysia (2023). Press statement by the Director-General of Health – current situation of dengue fe-ver in Malaysia for the year 2022. https://www.moh.gov.my/index.php/database_stores/store_view_page/17/2259
9. Ismail A, Nawi AM, Mohamed A (2015). Communication for behavioural impact (COMBI) program in dengue prevention evaluation: mixed methods approach. Int Med J, 22 (5): 367–70.
10. Packierisamy PR, Ng CW, Dahlui M, et al (2015). Cost of dengue vector control ac-tivities in Malaysia. Am J Trop Med Hyg, 93 (5): 1020–1027.
11. Alam K, Tasneem S, Oliveras E (2012). Per-formance of female volunteer commu-nity health workers in Dhaka urban slums. Soc Sci Med, 75 (3): 511–5.
12. Chung MHL, Hazmi H, Cheah WL (2017). Role performance of community health volunteers and its associated factors in Kuching district, Sarawak. J Environ Pub-lic Health, 2017:9610928.
13. Chatio S, Welaga P, Tabong PTN, Akweon-go P (2019). Factors influencing perfor-mance of community-based health vol-unteers’ activities in the Kassena-Nankana Districts of Northern Ghana. PLoS One, 14(2):e0212166.
14. Watanabe O, Chompikul J, Mongkolchati A, Pimpisan N (2014). Performances of village health volunteers in elderly care in Muang District, Nakhon Ratchasima Province, Thailand. J Public Health Dev, 12 (2): 3-15.
15. Rohmani N, Utari D (2021). The role of leadership and its relationship with the performance of community health vol-unteer: a survey in rural Indonesia. Dis Prev Public Health J, 15 (2): 103–9.
16. Lourdes T, Shakira W, Hasani R, et al (2016). Training is an important factor for community health workers in per-forming KOSPEN health screening ac-tivities in Malaysia: community health workers (KOSPEN) 2016. Int J Public Health Res, 11 (2): 1439–47.
17. Wahl B, Lehtimaki S, Germann S, Schwalbe N (2020). Expanding the use of commu-nity health workers in urban settings: a potential strategy for progress towards universal health coverage. Health Policy Plan, 35 (1): 91–101.
18. Sondaram NK, Kadir SH, Manaf RA (2018). Factors associated with knowledge of healthy community, empowers nation (KOSPEN) and its implementation among community health volunteers in Kulim District, 2017. Malaysian J Med Health Sci, 14 (2): 7–16.
19. Sophia M, Khairi M, Aisyah S, et al (2021). Knowledge, attitude and practice on dengue fever prevention among com-munities in Mutiara Ville, Cyberjaya. Mal J Med Health Sci, 17(SUPP11): 95-104.
20. Nasir Abdullah M, Nor Hazimah Wan Azib W, Fauzi Mohd Harun M, Addin Burhanuddin M (2013). Reliability and construct validity of knowledge, attitude and practice on dengue fever preven-tion questionnaire. Am Int J Contemp Res, 3(5): 69-75.
21. Weiss D, Dawis R, England G, Lofquist L (1967). Manual for the Minnesota Satis-faction Questionnaire. University of Minnesota. https://vpr.psych.umn.edu/sites/vpr.umn.edu/files/files/monograph_xxii_-_manual_for_the_mn_satisfaction_questionnaire.pdf
22. Olalere AB (2013). Effect of motivation on job performance by community devel-opment workers in Osun State, Nigeria. Int J Community Dev, 1 (2): 48-57.
23. Ghasemi A, Zahediasl S (2012). Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab, 10 (2): 486–9.
24. Mishra P, Pandey CM, Singh U, Gupta A, Sahu C, Keshri A (2019). Descriptive sta-tistics and normality tests for statistical data. Ann Card Anaesth, 22 (1): 67–72.
25. Hosmer DW, Lemeshow S (2013). Applied logistic regression. 3rd ed. Hoboken, New Jersey: John Wiley & Sons.
26. Alam K, Tasneem S, Oliveras E (2012). Re-tention of female volunteer community health workers in Dhaka urban slums: a case-control study. Health Policy Plan, 27 (6): 477–86.
27. Kok M, Dieleman M, Taegtmeyer M, et al (2015). Which intervention design fac-tors influence performance of commu-nity health workers in low- and middle-income countries? a systematic review. Health Policy Plan, 30(9): 1207–27.
28. Sarma H, Jabeen I, Luies SK, et al (2020). Performance of volunteer community health workers in implementing home-fortification interventions in Bangla-desh: a qualitative investigation. PLoS One, 15 (4):e0230709.
29. Department of Statistics Malaysia (2022). Current population estimates Malaysia 2022. https://www.dosm.gov.my/portal-main/release-content/current-population-estimates-malaysia-2022
30. Ahmad Fahmy WF, Haron N, Lim SC, et al (2022). Building the capacity of commu-nity health volunteers for non-communicable disease prevention in low-income urban communities in Ma-laysia. J Glob Health Rep, 6: e2022042.
31. Kuule Y, Dobson AE, Woldeyohannes D, et al (2017). Community health volun-teers in primary healthcare in rural Uganda: factors influencing perfor-mance. Front Public Health, 5: 62.
32. Department of Statistics Malaysia (2022). Key findings population and housing census of Malaysia 2020 report. https://www.mycensus.gov.my/index.php/census-product/publication/175-census-2020/1816-key-findings-of-census-2020
33. Kawakatsu Y, Sugishita T, Tsutsui J, et al (2015). Individual and contextual factors associated with community health work-ers’ performance in Nyanza Province, Kenya: a multilevel analysis. BMC Health Serv Res, 15:442.
34. Mostafa H, Lim Y (2020). Examining the re-lationship between motivations and re-silience in different international stu-dent groups attending U.S. universities. J Int Stud, 10 (2): 306–19.
35. Resnick B (2018). The relationship between resilience and motivation. In: Resilience in Aging. Springer, Cham, p. 221–44.
36. Woolfolk A (2019). Educational Psychology. 14th ed. Pearson Education.
37. Snelgar R, Shelton SA, Giesser A (2017). A comparison of South African and Ger-man extrinsic and intrinsic motivation. South African Journal of Economic and Man-agement Sciences, 20 (1): e1552.
38. Fatehi B, Karimi A, Pour EG, et al (2015). Impact of quality of work life on job satisfaction. Int J Sport Stud, 5 (1): 79–86.
39. Inayat W, Jahanzeb Khan M (2021). A study of job satisfaction and its effect on the performance of employees working in private sector organizations, Peshawar. Educ Res Int, 2021 (1):1-9.
40. Wang H, Jin Y, Wang D, et al (2020). Job satisfaction, burnout, and turnover inten-tion among primary care providers in rural China: results from structural equa-tion modeling. BMC Fam Pract, 21 (1): 12.
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| Issue | Vol 53 No 12 (2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Performance level Success community Community health volunteers COMBI program | ||
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How to Cite
1.
Abdul Razak MIF, Ahmad Fauzi F, Mohd Zulkefli NA. Unlocking Success: Determining Predictors of High-Performance among COMBI Community Health Volunteers in Kuala Lumpur and Putrajaya. Iran J Public Health. 2024;53(12):2768-2778.
