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Ugandan community health worker motivation: using the Social Identity Approach to explore an accepted constraint to scaled up health strategies

Strachan, Daniel Llywelyn; (2019) Ugandan community health worker motivation: using the Social Identity Approach to explore an accepted constraint to scaled up health strategies. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

The aim of this PhD is to understand what influences the work motivation of Ugandan community health workers (CHWs) using the Social Identity Approach (SIA); a social psychological theory. The SIA was chosen because it focuses on how group dynamics influence behaviours. Using the SIA heeds calls in the literature for improved social and contextual understanding of CHW work motivation and performance in order to guide development of more effective programmes. In the PhD it is reported how two interventions aiming to improve CHW work motivation were developed based on qualitative, formative research data and the SIA. The first intervention utilised low cost mobile phones and the second community participatory groups. The interventions were tested as part of a larger study using a cluster randomised control trial (RCT) design. This required the development of valid CHW work motivation and social identification measurement scales. While the results of the RCT are not presented within this PhD, the development of the two scales and descriptive statistics of the quantitative measures are. Analyses of data generated through qualitative, cognitive interviews and quantitative scale development techniques are also included. The results of qualitative, associative interviews conducted with CHWs during intervention implementation are also presented. These interviews aimed to explore and explain the nature of the relationship between CHW work motivation and social identification and the influence on it of the two interventions measured during the trial. This PhD demonstrates how the SIA can be used to understand the social and contextual influences on CHW work motivation and performance. This represents a new approach to developing effective CHW work motivation programmes. It has highlighted in particular the importance of distinguishing between task based and extra role performance motivation. Implications for programmes and researchers seeking to understand and influence CHW work motivation and performance are discussed.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Ugandan community health worker motivation: using the Social Identity Approach to explore an accepted constraint to scaled up health strategies
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/ by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
Keywords: Community Health Workers, Motivation, Social Identity Approach, Uganda, Mixed methods
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10073256
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