Exploring Intrinsic Factors Motivating Community Health Volunteers to Promote Cervical Cancer Screening, Isiolo Subcounty

Abstract

Introduction: Community Health Volunteers (CHVs) provide healthcare services such as basic curative, promoting and preventive healthcare services at the community level. While CHVs role is outlined at policy level, their engagement at the county level is still sub-optimal influencing their motivation. Other than remuneration, CHVs can be motivated by other intrinsic factors such as recognition. Unlike other cancers, cervical cancer is treatable when identified early by screening and early diagnosis. However, the uptake of screening services in Kenya is still low among eligible women. Therefore, to encourage uptake of screening by eligible women, CHVs need to be utilized to create awareness at the community level. Objective: Study aimed at exploring the intrinsic motivation factors that influence CHVs in promoting cervical cancer screening. Methodology: This was a qualitative study conducted in Isiolo Sub-County. Sixteen CHV leads were purposively selected to participate in individual interviews conducted between January and February 2021. The interviews were audio-taped, transcribed and analyzed using thematic content analysis. Results: Fourteen out of 16 participants were competent having demonstrated knowledge on cervical cancer and screening. However, 13 out of 16 did not know the type of screening services offered. All the participants had a good relationship with their supervisors. The average time spent each day doing CHV work was 3.6 hours. Participants rated their job satisfaction in relation to promoting cervical cancer screening very lowly at 2.8 on a scale of 10 due to lack of capacity building and facilitation to work diligently at the community level. All the CHVs (N=16) attributed their motivation to service to community and to God. Eleven out of 16 attributed their satisfaction to gaining and utilizing new knowledge. Conclusion: The CHVs were not satisfied with their role in creating awareness to promote cervical cancer screening. Factors such as average level of knowledge on cervical cancer and inconsistent support supervision were the main factors that contributed to dissatisfaction of CHVs and influenced their performance on creating awareness for cervical cancer screening Recommendation: Subject specific training is needed to improve CHVs knowledge on cervical cancer screening and consistent close supervision provided to ensure optimal performance by CHVs.