Use of Lot quality assurance sampling surveys to evaluate community health worker performance in rural Zambia: a case of Luangwa ... View Full Text


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Article Info

DATE

2017-12

AUTHORS

Moses Mwanza, Japhet Zulu, Stephanie M. Topp, Patrick Musonda, Wilbroad Mutale, Roma Chilengi

ABSTRACT

BACKGROUND: The Better Health Outcomes through Mentoring and Assessment (BHOMA) project is a cluster randomized controlled trial aimed at reducing age-standardized mortality rates in three rural districts through involvement of Community Health Workers (CHWs), Traditional Birth Attendants (TBAs), and Neighborhood Health Committees (NHCs). CHWs conduct quarterly surveys on all households using a questionnaire that captures key health events occurring within their catchment population. In order to validate contact with households, we utilize the Lot Quality Assurance Sampling (LQAS) methodology. In this study, we report experiences of applying the LQAS approach to monitor performance of CHWs in Luangwa District. METHODS: Between April 2011 and December 2013, seven health facilities in Luangwa district were enrolled into the BHOMA project. The health facility catchment areas were divided into 33 geographic zones. Quality assurance was performed each quarter by randomly selecting zones representing about 90% of enrolled catchment areas from which 19 households per zone where also randomly identified. The surveys were conducted by CHW supervisors who had been trained on using the LQAS questionnaire. Information collected included household identity number (ID), whether the CHW visited the household, duration of the most recent visit, and what health information was discussed during the CHW visit. The threshold for success was set at 75% household outreach by CHWs in each zone. RESULTS: There are 4,616 total households in the 33 zones. This yielded a target of 32,212 household visits by community health workers during the 7 survey rounds. Based on the set cutoff point for passing the surveys (at least 75% households confirmed as visited), only one team of CHWs at Luangwa high school failed to reach the target during round 1 of the surveys; all the teams otherwise registered successful visits in all the surveys. CONCLUSIONS: We have employed the LQAS methodology for assurance that quarterly surveys were successfully done. This methodology proved helpful in identifying poorly performing CHWs and could be useful for evaluating CHW performance in other areas. TRIAL REGISTRATION: Identifier: NCT01942278 . Date of Registration: September 2013. More... »

PAGES

279

References to SciGraph publications

  • 2013-12. Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review in BMC PUBLIC HEALTH
  • 2012-12. The experience of community health workers training in Iran: a qualitative study in BMC HEALTH SERVICES RESEARCH
  • 2014-05. Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process in BMC HEALTH SERVICES RESEARCH
  • 2013-12. Developing the national community health assistant strategy in Zambia: a policy analysis in HEALTH RESEARCH POLICY AND SYSTEMS
  • 2012-12. Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach in BMC HEALTH SERVICES RESEARCH
  • 2013-12. The effect of clustering on lot quality assurance sampling: a probabilistic model to calculate sample sizes for quality assessments in EMERGING THEMES IN EPIDEMIOLOGY
  • 2010-12. Are we doing enough? Evaluation of the Polio Eradication Initiative in a district of Pakistan's Punjab province: a LQAS study in BMC PUBLIC HEALTH
  • 2009-12. Task shifting: the answer to the human resources crisis in Africa? in HUMAN RESOURCES FOR HEALTH
  • 2012-12. Intervene before leaving: clustered lot quality assurance sampling to monitor vaccination coverage at health district level before the end of a yellow fever and measles vaccination campaign in Sierra Leone in 2009 in BMC PUBLIC HEALTH
  • 2013-05. Protocol-driven primary care and community linkages to improve population health in rural Zambia: the Better Health Outcomes through Mentoring and Assessment (BHOMA) project in BMC HEALTH SERVICES RESEARCH
  • 2013-12. Why is greater medication adherence associated with better outcomes in EMERGING THEMES IN EPIDEMIOLOGY
  • 2010-12. A realist synthesis of randomised control trials involving use of community health workers for delivering child health interventions in low and middle income countries in BMC HEALTH SERVICES RESEARCH
  • 2009-12. The role of community health workers in improving child health programmes in Mali in BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS
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    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28416009


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