Research
Job stress among community health workers: a multi-method study from Pakistan
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* Corresponding author: Atif Rahman atifrahman@sky.com
- † Equal contributors
1 Pakistan Initiative for Mothers and Newborns (PAIMAN) House 6, Street 5, F-8/3, Islamabad, Pakistan
2 Human Development Research Foundation, Pakistan
3 University of Liverpool, Liverpool, UK
International Journal of Mental Health Systems 2008, 2:15 doi:10.1186/1752-4458-2-15
Published: 28 October 2008Abstract
Background
In low income countries, the task of providing primary health care is often the responsibility of community health workers. In Pakistan, community workers called Lady Health Workers (LHW) deliver basic health care at the doorstep in the rural areas and urban slums. Evaluations show that it is a successful programme but point out inconsistencies in the quality of service provided. In order achieve this, it would be important to obtain the workers' viewpoint on their job-description, the problems they face and the levels of stress they encounter.
Methods
We conducted a multi-method study to investigate the aforementioned issues. All LHWs from one typical rural sub-district in Rawalpindi were surveyed. Focus group discussions with a sub-set of these workers were also conducted.
Results
About a quarter of the LHWs were found to have significant occupational stress. Factors associated with stress included having low socio-economic status and having to travel long distances for work. Inconsistent medical supplies, inadequate stipends, lack of career structure and not being equipped to communicate effectively with families were the main factors for job dissatisfaction among these workers.
Recommendations
Improvement in remuneration, better administration of supplies and a structured career path should be ensured for better performance of community health workers. In addition, communication skills learning should be an essential part of their training programme.