Challenges of the National Program of Health Volunteers in Iran

Document Type : Original Article

Authors

1 mashhad university of medical sciences

2 school of health

Abstract

Background and Objective: One of the fundamental points of primary health care (PHC) is the principle of social participation, which the program of health volunteers is one of its successful samples. Considering the significant role of health volunteers in promoting social health, the present study was conducted to determine the challenges of the national program of health volunteers in Iran as an example of a lower middle-income country.

Materials and Methods: This qualitative study was carried out among public health authorities healthy volunteers at the national level. For this purpose, 42 interviews were performed in a semi-structured manner with healthy volunteers nationwide. In order to data analysis, MAXQDA 10 software was used.

Results: Based on the results of the content analysis test, 349 primary codes were revealed. By considering the integration and overlapping of the codes, 4 main challenges (Coordination, Participation, Structure, and Motivation), as well as fourteen sub-themes, were obtained.

Conclusion: According to the results of the research, interaction and participation were important principles of development and the participation of other sectors should get along with the participation of the people. Also, the biggest issue in the program of health volunteers can be associated with its credibility.

Keywords


1. Yansaneh AI, George AS, Sharkey A, Brieger WR, Moulton LH, Yumkella F, et al. Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone. Journal of community health. 2016;41(2):376-86.
https://doi.org/10.1007/s10900-015-0107-0
PMid:26507650
 
2. Taguchi A, Murayama H, Murashima S. Association between Municipal Health Promotion Volunteers' Health Literacy and Their Level of Outreach Activities in Japan. PLoS One. 2016;11(10):e0164612.
https://doi.org/10.1371/journal.pone.0164612
PMid:27736942 PMCid:PMC5063291
 
3. Tabassum F, Mohan J, Smith P. Association of volunteering with mental well-being: a lifecourse analysis of a national population-based longitudinal study in the UK. BMJ open. 2016;6(8):e011327.
https://doi.org/10.1136/bmjopen-2016-011327
PMid:27503861 PMCid:PMC4985873
 
4. zareipour M, Fattahi Ardakani M, Sotoudeh A, Tasouji Azari M. The Importance of Tele Education of Family Health Ambassadors in COVID -19 Prevention. Journal of Health Literacy. 2021;6(1):9-12.
 
5. Jafari Y, Tehrani H, Esmaily H, Shariati M, Vahedian‐shahroodi M. Family‐centred empowerment program for health literacy and self‐efficacy in family caregivers of patients with multiple sclerosis. Scandinavian journal of caring sciences. 2020;34(4):956-63.
https://doi.org/10.1111/scs.12803
PMid:31985862
 
6. Byrne F, Grace R, Tredoux J, Kemp L. Structured social relationships: a review of volunteer home visiting programs for parents of young children. Australian health review : a publication of the Australian Hospital Association. 2016;40(3):262-9.
https://doi.org/10.1071/AH15057
PMid:26456798
 
7. Kharaghani K, Habibpour ghatabi K, Barandeghi B. The Role of Tehranian Citizens' Participation in Realization «Tobacco-Free Tehran Programme». Iranian Journal of Health Education and Health Promotion. 2020;8(1):82-92.
https://doi.org/10.29252/ijhehp.8.1.82
 
8. Dolovich L, Gaber J, Valaitis R, Ploeg J, Oliver D, Richardson J, et al. Exploration of volunteers as health connectors within a multicomponent primary care-based program supporting self-management of diabetes and hypertension. . Health Soc Care Community. 2020;28(3):734-46. doi: 10.1111/hsc.12904. Epub 2019 Nov 28. PMID: 31777125.
https://doi.org/10.1111/hsc.12904
PMid:31777125
 
9. Gaber J, Oliver D, Valaitis R, Cleghorn L, Lamarche L, Avilla E, et al. Experiences of integrating community volunteers as extensions of the primary care team to help support older adults at home: a qualitative study. BMC Fam Pract. 2020;21(1):92. doi: 10.1186/s12875-020-01165-2. PMID: 32416718; PMCID: PMC7231411.
https://doi.org/10.1186/s12875-020-01165-2
PMid:32416718 PMCid:PMC7231411
 
10. Rezakhani Moghaddam H, Shojaeizadeh D, Taghdisi M, Hamidzadeh Arbabi Y, Savadpour M. Journal of School of Public Health and Institute of Public Health Research. The effect of education by community health volunteers on choice of delivery kind in pregnant women based on the Behavioral Intention Model BIM. 2013;10(3):27-40.
 
11. Farsar AR, Younesi M, Fattahi L, Ahmadnia H, Mohammadinia N, B. K, et al. Comparison of the Performance of Health Volunteers in the Health Centers of Shahid Beheshti University of Medical Sciences. Community Health. 2014;1(1):11-20.
 
12. Kuule Y, Eric Dobson A, Woldeyohannes D, Zolfo M NR, MR, Edwin B. Community Health Volunteers in Primary Healthcare in Rural Uganda: Factors Influencing Performance. 2017:62.
https://doi.org/10.3389/fpubh.2017.00062
PMid:28424765 PMCid:PMC5372810
 
13. Rezakhani Moghaddam H, Allahveripour h, Matlabi h. Successful recruitment and retention strategies for women health volunteers: viewpoints of the volunteers' supervisors and relevant researchers. Journal of Multidisciplinary Healthcare 2018;11:621-34.
https://doi.org/10.2147/JMDH.S180544
PMid:30464495 PMCid:PMC6208547
 
14. Ratelle JT, Sawatsky AP, Beckman TJ. Quantitative Research Methods in Medical Education. Anesthesiology. 2019;131(1):23-35. doi: 10.1097/ALN.0000000000002727. PMID: 31045900.
https://doi.org/10.1097/ALN.0000000000002727
PMid:31045900
 
15. Guba EG, Lincoln Y. Effective evaluation: improving the usefulness of evaluation results through responsive and naturalistic approaches. San Francisco: Jessey- Bass; 1981.
 
16. Javanparast S, Baum F, Labonte R, Sanders D. Community health workers' perspectives on their contribution to rural health and well-being in Iran. Am J Public Health. 2011;101(12):2287-92.
https://doi.org/10.2105/AJPH.2011.300355
PMid:22021303 PMCid:PMC3222427
 
17. Hoodfar H. Health as a context for social and gender activism: female volunteer health workers in Iran. PopulDev Rev. 2010;36(3):487-510.
https://doi.org/10.1111/j.1728-4457.2010.00343.x
PMid:20882703
 
18. Kok MC, Kane SS, Tulloch O, Ormel H, Theobald S, Dieleman M, et al. How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature. Health Res Policy Syst. 2015;13(13):doi:10.1186/s12961-015-0001-3.
https://doi.org/10.1186/s12961-015-0001-3
PMid:25890229 PMCid:PMC4358881
 
19. Maher D, G. C. Research on community-based health workers is needed to achieve the sustainable development goals. Bull World Health Organ. 2016;94(786):doi:10.2471/BLT.16.185918.
https://doi.org/10.2471/BLT.16.185918
PMid:27821877 PMCid:PMC5096357
 
20. Kambarami RA, Mbuya MN, Pelletier D, Fundira D, Tavengwa NV, RJ. S. Factors associated with Community Health Worker performance differ by task in a multi-tasked setting in rural Zimbabwe. . Glob Health Sci Pract. 2016;4:238-50. doi:10.9745/GHSP-D-16-00003.
https://doi.org/10.9745/GHSP-D-16-00003
PMid:27353617 PMCid:PMC4982248
 
21. Vareilles G, Pommier J, Kane S, Pictet G, Marchal B. Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation protocol. BMJ Open. 2015;5:e006752. doi:10.1136/bmjopen-2014-
https://doi.org/10.1136/bmjopen-2014-006752
PMid:25631314 PMCid:PMC4316434
 
22. Singh D, Negin J, Orach CG, Cumming R. Supportive supervision for volunteers to deliver reproductive health education: a cluster randomized trial. Reprod Health. 2016;13(126):doi:10.1186/s12978-016-0244-7
https://doi.org/10.1186/s12978-016-0244-7
PMid:27716313 PMCid:PMC5048471
 
23. Mercader HFG, Kyomuhangi T, Buchner DL, Kabakyenga J, JL. B. Drugs for some but not all: inequity within community health worker teams during introduction of integrated community case management. . BMC Health Serv Res. 2014;14(Suppl 1):S1:doi:10.1186/472-6963-14-S1-S1.
https://doi.org/10.1186/1472-6963-14-S1-S1
PMid:25078968 PMCid:PMC4108853
 
24. Naharuddin NM, Sadegi M. Factors of workplace environment that affect employees performance: a case study of Miyazu Malaysia. Int J Independent Res Stud (2013;2(66).
 
25. Kok MC, Dieleman M, Taegtmeyer M, Broerse JE, Kane SS, Ormel H, et al. Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review. Health Policy Plan. 2015;30:1207-27. doi:10.093/heapol/czu126
https://doi.org/10.1093/heapol/czu126
PMid:25500559 PMCid:PMC4597042
 
26. Kawakatsu Y, Sugishita T, Kioko J, Ishimura A, S. H. Factors influencing the performance of community health workers in Kisumu West, Kenya. Health Care Res Dev. 2012;13:294-300. doi:10.1017/S1463423612000138.
https://doi.org/10.1017/S1463423612000138
PMid:22717333
 
27. Turinawe EB, Rwemisisi JT, Musinguzi LK, de Groot M, Muhangi D, Mafigiri DK, et al. Towards promotion of community rewards to volunteer community health workers? Lessons from experiences of village health teams in Luwero, Uganda. Res Health Sci. 2016;1(85): doi:10.22158/rhs.
https://doi.org/10.22158/rhs.v1n2p85