Community health workers – motivation and incentives

The Community Health Worker (CHW) literature is expansive, covering more than 30 years of interest in the concept. Despite this, understanding of CHW motivation and the effectiveness of monetary incentives is limited. Using self-determination theory (SDT) as an explanatory framework, the article outlines some of the roles and functions that CHWs have filled within health and community systems, CHW motivation, and how different factors either enhance or detract from this.

Agents de santé communautaires – motivation et incitations

Les documents portant sur les agents de santé communautaires (ASC) sont nombreux et couvrent plus de 30 ans d'intérêt dans ce concept. En dépit de cela, la compréhension de la motivation des ASC et de l'efficacité des incitations monétaires est limitée. En utilisant la théorie de l'autodétermination (TAD) comme cadre explicatif, cet article présente quelques-uns des rôles et des fonctions que les ASC ont remplis dans le cadre de systèmes sanitaires et communautaires, la motivation des ASC et la manière dont différents facteurs soit la renforcent soit l'affaiblissent.

Trabajadores de salud comunitarios - motivación e incentivos

Existen numerosas investigaciones sobre los trabajadores de salud comunitarios (tsc), que abarcan los más de 30 años durante los cuales el concepto ha sido objeto de estudio. A pesar de lo anterior, las motivaciones de los tsc y la eficacia de los incentivos monetarios no son ampliamente comprendidas. Con el apoyo de la teoría de la autodeterminación como marco analítico, el presente artículo expone algunos de los roles y de las funciones desempeñados por los tsc en los sistemas de salud comunitarios, así como las motivaciones que los impulsan, analizando, a la vez, los distintos factores que alientan o desincentivan tales motivaciones.

Trabalhadores comunitários da saúde – motivação e incentivos

A literatura sobre Trabalhadores Comunitários da Saúde (TCSs) é extensa, abrangendo mais de 30 anos de interesse no conceito. Apesar disto, o entendimento sobre a motivação dos TCSs e da efetividade de incentivos monetários é limitado. Utilizando a Teoria da Auto-Determinação (TAD) como estrutura explicativa, o artigo apresenta algumas das tarefas e funções que os TCSs têm realizado dentro dos sistemas de saúde e comunidade, a motivação dos TCSs e como fatores diferentes melhoram ou agravam a partir disto.     

Pro-poor budget analysis of Kenya's free primary education policy

This practical note outlines Concern's approach to pro-poor budget analysis using the case of the Kenya Free Primary Education (FPE) policy. Analysis conducted on the outcomes of the FPE policy for Nairobi's urban slum-based poor suggests that the policy is not being implemented evenly within the city. The reasons stem from poor allocation and planning approaches, to political interference and unwillingness of teachers to work in slum-based schools. These have the unintended effect of increasing inequities for the urban poor, the reverse of the policy intention. The note outlines the pitfalls and practicalities of conducting this type of analysis.     

Women's groups for whom? The colonisation of women's groups in Papua New Guinea

This paper explores the issues concerning women's groups in the context of women's network in Papua New Guinea (PNG) and from an association with such a network in West New Britain province. The women's groups in PNG often came into existence under the influence of colonial rule and as an adjunct to the Church. Some 20 years later, their vulnerability to colonization by other development factors--whether the state, the donor agency, or the beneficiaries--remains an issue for these groups because of their ambiguity of function and purpose. Despite this ambiguity, and in spite of the women subsuming a passive role in the face of the state and the donor, the women themselves have their own individual strategies for accumulating symbolic as well as real resources. However, the strategy is only open to a handful of women, whose position in society depends on the fact that prevailing patriarchal gender relations are continued. In addition, it is suggested that by simply existing, women's groups in PNG have continued to aid and abet the masculine tradition within the provincial and district governments.     

Exploring strengths-based approaches in the design of a family planning project in Kenya

This practical note explores the contribution that strengths-based approaches (SBA) can make to project design. The note outlines how SBA was understood and applied in the design of a family planning project by Marie Stopes in Kenya under the Australian Africa Community Engagement Scheme (AACES). Fieldwork findings demonstrate how SBA assists in bringing to the fore local initiatives and assets that can be built on by external resources. It further suggests that SBA can create a strong foundation for local partnership, honest appraisal, and learning.

Examen des approches basées sur les points forts dans la conception d'un projet de planning familial

Cette note pratique examine la contribution que les approches basées sur les points forts (ABPF) peuvent apporter à la conception des projets. La note décrit comment l'ABPF a été comprise et appliquée dans le cadre de la conception d'un projet de planning familial par Marie Stopes au Kenya, entrepris au titre du programme australien Africa Community Engagement Scheme (AACES). Les conclusions tirées lors d'une mission sur le terrain montrent la manière dont l'ABPF peut aider à mettre au premier plan des initiatives et atouts qui peuvent être développés par des ressources externes. Il est aussi suggéré que l'ABPF peut donner lieu à une fondation solide pour des partenariats locaux, à une estimation honnête et à l'apprentissage.

Explorando abordagens baseadas nos pontos fortes na criação de um projeto de planejamento familiar

Esta nota prática examina a contribuição que abordagens baseadas nos pontos fortes (SBA) pode dar na criação do projeto. A nota apresenta como o SBA foi compreendido e aplicado na criação de um projeto de planejamento familiar de Marie Stopes, no Quênia, sob o Esquema Australiano de Engajamento da Comunidade da África (AACES). Os resultados do trabalho de campo mostram como o SBA ajuda a colocar em evidência iniciativas locais e bens que podem ser construídos através de recursos externos. Ele sugere ainda que o SBA pode criar uma fundação sólida para parceria local, avaliação honesta e aprendizado.

Un análisis de métodos basados en las fortalezas para la elaboración de un proyecto de planificación familiar

Esta nota práctica analiza los aportes de los métodos basados en las fortalezas (MBF) para la elaboración de proyectos. Se revisa cómo Marie Stopes entendió y aplicó un MBF para elaborar un proyecto de planificación familiar en Kenia, en el marco del Plan para la Participación Comunitaria Australiano-Africana. Las conclusiones derivadas del trabajo de campo demuestran cómo el MBF puede ayudar a situar las iniciativas y los activos locales en primer plano, y a fortalecerlos con recursos externos. También revela que el MBF puede crear una sólida base para las asociaciones locales, las evaluaciones sinceras y el aprendizaje.