Title: Quality of care at the household level: the field worker's perspective.

POPLINE Document Number: 271783

Author(s):

Brechin SJ
Koblinsky MA

Source citation:

Dhaka, Bangladesh, International Centre for Diarrhoeal Disease Research, Bangladesh, MCH-FP Extension Project, 1988 Apr. 22 p. (ICDDR, B MCH-FP Extension Project Operations Paper No. 64)

Abstract:

Analysis of the determinants of the quality of care provided at the household level in rural Bangladesh examined several areas where changes have been and are being made to increase the family welfare assistant's (FWA) ability to give quality care within the existing system in which she works. As seen in Appendix 1, some interventions such as increasing worker density and testing of domiciliary provision of injectable contraceptives involve policy decisions at national level while others are lower-level interventions from the upazila. Most of the changes discussed fall within the 2 major interventions of the worker density study and development of national training materials. Recruiting and training 10,000 new FWA's will eventually have its effect on decreasing the worker-to-population ratio, and FWA's will have smaller target populations to visit. These new FWA's will have field-based training conducted by both upazila officials as well as regular training staff. The manuals being used are based on field experience in rural Bangladesh and emphasize the importance of set standards of practice and promotion of linkages with technical and administrative supervisors. As the FWA continues to be the critical link between rural Bangladesh women and the outside world for health care, maximum use of her routine household visits should be made, after careful assessment of her ability to do all the tasks in her job description. It is recommended that there be clarification of the tasks falling under each duty in the FWA's present job description to guide her in her work as well as examination of the level of effort needed for each duty. The feasibility of the FWA providing a mix of preventive and curative services and education should be determined in a pilot project. (Author's)

Keywords:

Bangladesh
Quality of Health Care
Community Workers
Home Visits
Family Planning Program Evaluation
Recruitment Activities
Training Activities
Household Distribution
Family Planning Personnel
Operations Research
Tables and Charts
Field Workers
Time Factors
Family Planning Personnel Evaluation
Evaluation Methodology
Maternal-Child Health Services
Integrated Programs
Asia, Southern
Asia
Developing Countries
Health Services Evaluation
Program Evaluation
Programs
Organization and Administration
Health Personnel
Delivery of Health Care
Health
Communication
Family Planning Programs
Family Planning
Program Activities
Training Programs
Education
Nonclinical Distribution
Distributional Activities
Research Methodology
Population Dynamics
Demographic Factors
Population
Evaluation
Primary Health Care
Health Services