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The effect of payment and incentives on motivation and focus of community health workers: five case studies from low- and middle-income countries

Overview of attention for article published in Human Resources for Health, July 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (84th percentile)

Mentioned by

2 policy sources
6 tweeters


43 Dimensions

Readers on

263 Mendeley
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The effect of payment and incentives on motivation and focus of community health workers: five case studies from low- and middle-income countries
Published in
Human Resources for Health, July 2015
DOI 10.1186/s12960-015-0051-1
Pubmed ID

Debra Singh, Joel Negin, Michael Otim, Christopher Garimoi Orach, Robert Cumming


Community health workers (CHWs) have been proposed as a means for bridging gaps in healthcare delivery in rural communities. Recent CHW programmes have been shown to improve child and neonatal health outcomes, and it is increasingly being suggested that paid CHWs become an integral part of health systems. Remuneration of CHWs can potentially effect their motivation and focus. Broadly, programmes follow a social, monetary or mixed market approach to remuneration. Conscious understanding of the differences, and of what each has to offer, is important in selecting the most appropriate approach according to the context. The objective of this review is to identify and examine different remuneration models of CHWs that have been utilized in large-scale sustained programmes to gain insight into the effect that remuneration has on the motivation and focus of CHWs. A MEDLINE search using Ovid SP was undertaken and data collected from secondary sources about CHW programmes in Iran, Ethiopia, India, Bangladesh and Nepal. Five main approaches were identified: part-time volunteer CHWs without regular financial incentives, volunteers that sell health-related merchandise, volunteers with financial incentives, paid full-time CHWs and a mixed model of paid and volunteer CHWs. Both volunteer and remunerated CHWs are potentially effective and can bring something to the health arena that the other may not. For example, well-trained, supervised volunteers and full-time CHWs who receive regular payment, or a combination of both, are more likely to engage the community in grass-roots health-related empowerment. Programmes that utilize minimal economic incentives to part-time CHWs tend to limit their focus, with financially incentivized activities becoming central. They can, however, improve outcomes in well-circumscribed areas. In order to maintain benefits from different approaches, there is a need to distinguish between CHWs that are trained and remunerated to be a part of an existing health system and those who, with little training, take on roles and are motivated by a range of contextual factors. Governments and planners can benefit from understanding the programme that can best be supported in their communities, thereby maximizing motivation and effectiveness.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 263 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 1 <1%
Brazil 1 <1%
South Africa 1 <1%
Sierra Leone 1 <1%
Congo, The Democratic Republic of the 1 <1%
Unknown 258 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 71 27%
Researcher 50 19%
Student > Ph. D. Student 41 16%
Student > Postgraduate 17 6%
Student > Bachelor 17 6%
Other 48 18%
Unknown 19 7%
Readers by discipline Count As %
Medicine and Dentistry 80 30%
Social Sciences 49 19%
Nursing and Health Professions 38 14%
Economics, Econometrics and Finance 19 7%
Business, Management and Accounting 8 3%
Other 34 13%
Unknown 35 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 May 2019.
All research outputs
of 13,918,259 outputs
Outputs from Human Resources for Health
of 751 outputs
Outputs of similar age
of 231,179 outputs
Outputs of similar age from Human Resources for Health
of 2 outputs
Altmetric has tracked 13,918,259 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 751 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.4. This one has gotten more attention than average, scoring higher than 67% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 231,179 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them