Volunteering for Health Services in the Middle Part of Ghana: In Whose Interest? (original) (raw)

Background: In many developing countries like Ghana, community volunteers assist in the provision of certain health services to rural and hard-to-reach communities. This study examined factors that influence the motivation and retention of community-based volunteers supporting with work on health-related activities at the community level in Ghana. Methods: Using a sequential mixed-method design, a cross-sectional survey was carried out among 205 selected community-based volunteers in Kintampo North Municipality (KNM) and Kintampo South District (KSD) of Ghana between December, 2014 and February, 2015. Qualitative interviews, including 12 in-depth interviews (IDIs) among health workers and community opinion leaders and 2 focus group discussion (FGD) sessions with volunteers were conducted. Results: Personal interest (32.7%) and community leaders' selection of volunteers (30.2%) were key initial reasons for volunteering. Monetary incentives such as allowance for extra duty (88.8%) and per diem (49.3%) and non-monetary incentives such as T-shirts/bags (45.4 %), food during training (52.7%), community recognition, social prestige and preferential treatment at health facilities were the facilitators of volunteers' retention. There was a weak evidence (P = .051) to suggest that per diem for their travels is a reason for volunteers' satisfaction. Conclusion: Community-based volunteers' motivation and retention were influenced by their personal interest in the form of recognition by community members and health workers, community leaders' selection and other non-monetary incentives. Volunteers were motivated by extra-duty allowance but not per diems paid for accommodation and feeding when they travel. Organizations that engage community volunteers are encouraged to strengthen the selection of volunteers in collaboration with community leaders, and to provide both non-monetary and monetary incentives to motivate volunteers. Implications for policy makers • Volunteer involving organizations should take note of monetary and non-monetary incentives among volunteers to help in their recruitment and retention. • Attention should be given to community leaders' selection of volunteers since it gives volunteers traditional authorization and also serve as an important motivation among them. • Healthcare managers and administrators should encourage the establishment of context-specific community incentive systems to motivate and retain volunteers. • There is the need for the Ministries of Health and health service managers to establish a general incentive package for volunteers in low resource settings to sustain their interest. Though the work is voluntary, volunteers work in relatively poor communities where the standard of living is relatively low. Incentives in the form of monthly honorarium (monetary) will motivate volunteers to give out their best to complement the health system. Implications for the public As part of addressing health workforce challenge particularly in developing countries community-based volunteers (CBVs) assist professional health workers to extend healthcare coverage and key health interventions to rural communities and some urban settings. The CBVs at our study site are no exception. However, our findings revealed that these volunteers do not receive salary for services rendered but volunteer to complement the staff strength of the local health system to improve on the health of their community. Understanding motivations of these volunteers is therefore important in order for healthcare managers and community/public to develop effective volunteer recruitment, motivation and retention strategies. Also community members/ public need to be sensitized that, Community-based Volunteers in Ghana are not paid as such they require community support to continue volunteering. The support could be recognition of their services through exemptions from communal labour, words of encouragement and helping volunteers to work on their farms periodically. Abstract In a recent article, Gorik Ooms has drawn attention to the normative underpinnings of the politics of global health. We claim that Ooms is indirectly submitting to a liberal conception of politics by framing the politics of global health as a question of individual morality. Drawing on the theoretical works of Chantal Mouffe, we introduce a conflictual concept of the political as an alternative to Ooms' conception. Using controversies surrounding medical treatment of AIDS patients in developing countries as a case we underline the opportunity for political changes, through political articulation of an issue, and collective mobilization based on such an articulation. Citation: Askheim C, Heggen K, Engebretsen E. Politics and power in global health: the constituting role of conflicts: Comment on " Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health.