Understanding volunteer community health worker motivation : a longitudinal cohort study in Sierra Leone

Abstract

Governments and non-profit organisations are once again turning to alternative cadres of health workers in an effort to accelerate health targets and address the severe global shortage of human resources for health. In low and middle-income contexts alike, a common approach involves the integration of community health workers (CHWs) into existing health systems. Rooted in self-determination theory and adopting a functionalist approach whereby apparent similar acts of volunteerism may reflect significantly different underlying motivations, this study explores the motives of volunteer CHWs taking part in a maternal and child health program in Bonthe District, Sierra Leone. Employing a longitudinal cohort design, it examines the realtionships between supervision, volunteer CHW motivation, work engagement and job satisfaction from CHW enrolment, through CHW training, and throughout their continued participation in the programme.