Table 3.
Individual, Supervisor’s and Community factors associated with CHWs’ performance in Kisumu West, Siaya, Ugenya and Gem districts, Nyanza Province, Kenya
| Model 0 | Model 1 | Model 2 | Model 3 | |||||
|---|---|---|---|---|---|---|---|---|
| Individual variables | Conf. | 95 % CI. | Conf. | 95 % CI. | Conf. | 95 % CI. | Conf. | 95 % CI. |
| Gender | ||||||||
| Female | Ref. | Ref | Ref. | |||||
| Male | −0.157 | −0.384-0.070 | −0.155 | −0.381-0.072 | −0.132 | −0.358-0.095 | ||
| Age group (years) | ||||||||
| <40 | Ref. | Ref. | Ref. | |||||
| ≥40 | −0.176 | −0.365-0.013 | −0.174 | −0.363-0.015 | −0.158 | −0.347-0.030 | ||
| Marital status | ||||||||
| Single/Divorced/Widowed | Ref. | Ref. | Ref. | |||||
| Married | 0.732 | −0.006-1.470 | 0.727 | −0.011-1.465 | *0.738 | 0.002-1.474 | ||
| Education level | ||||||||
| No education/primary school dropout | Ref. | Ref. | Ref. | |||||
| Primary level | ***0.654 | 0.395-0.913 | ***0.655 | 0.396-0.914 | ***0.651 | 0.393-0.909 | ||
| Secondary level or higher | ***0.934 | 0.679-1.190 | ***0.933 | 0.678-1.189 | ***0.928 | 0.674-1.183 | ||
| Number of household members | ||||||||
| Fewer than 6 | Ref. | Ref. | Ref. | |||||
| 6 or more | *0.201 | 0.014-0.388 | *0.202 | 0.015-0.389 | *0.199 | 0.013-0.386 | ||
| Number of children under five | ||||||||
| Fewer than 1 | Ref. | Ref. | Ref. | |||||
| 1 or more | −0.182 | −0.386-0.022 | −0.189 | −0.394-0.015 | −0.186 | −0.390-0.017 | ||
| Household wealth index | ||||||||
| Poorest | Ref. | Ref. | Ref. | |||||
| Poorer | 0.179 | −0.094-0.452 | 0.180 | −0.093-0.454 | 0.190 | −0.082-0.463 | ||
| Middle | 0.055 | −0.225-0.335 | 0.053 | −0.227-0.333 | 0.055 | −0.224-0.335 | ||
| Richer | 0.268 | −0.034-0.564 | 0.261 | −0.038-0.560 | 0.259 | −0.039-0.557 | ||
| Richest | 0.169 | −0.125-0.463 | 0.167 | −0.128-0.461 | 0.163 | −0.129-0.457 | ||
| Household sanitation practice | ||||||||
| Poor | Ref. | Ref. | Ref. | |||||
| Middle | 0.154 | −0.131-0.439 | 0.150 | −0.135-0.434 | 0.168 | −0.117-0.452 | ||
| Good | ***0.580 | 0.304-0.856 | ***0.583 | 0.307-0.860 | ***0.616 | 0.340-0.331 | ||
| Years working as CHWs | ||||||||
| Less than 4 years | Ref. | Ref. | Ref. | |||||
| 4 years or more | **0.339 | 0.129-0.549 | *0.330 | 0.119-0.540 | **0.327 | 0.118-0.537 | ||
| Number of households covered | ||||||||
| Less than 21 households | Ref. | Ref. | Ref. | |||||
| 21 or more | 0.159 | −0.041-0.359 | 0.143 | −0.058-0.345 | 0.131 | −0.069-0.331 | ||
| Job satisfaction | ||||||||
| Lowest | Ref. | Ref. | Ref. | |||||
| Low | 0.110 | −0.164-0.384 | 0.113 | −0.161-0.387 | 0.103 | −0.171-0.378 | ||
| Middle | 0.216 | −0.066-0.498 | 0.218 | −0.064-0.501 | 0.193 | −0.089-0.475 | ||
| High | −0.011 | −0.295-0.272 | −0.010 | −0.295-0.274 | −0.034 | −0.318-0.250 | ||
| Highest | −0.018 | −0.300-0.264 | −0.019 | −0.301-0.264 | −0.028 | −0.310-0.255 | ||
| Frequency of supervision received | ||||||||
| Less than monthly | Ref. | Ref. | Ref. | |||||
| Monthly | −0.156 | −0.437-0.124 | −0.150 | −0.431-0.130 | ***−0.717 | −1.191--0.242 | ||
| More frequently | ***−0.713 | −1.083--0.344 | ***−0.709 | −1.079--0.340 | ***−1.230 | −1.863--0.597 | ||
| Supervisor’s and community variables | Conf. | 95 % CI. | Conf. | 95 % CI. | Conf. | 95 % CI. | Conf. | 95 % CI. |
| CHEWs’ health knowledge | ||||||||
| Low | Ref. | Ref. | ||||||
| Middle | 0.096 | −1.113-1.305 | −0.280 | −1.614-1.053 | ||||
| High | 0.178 | −0.717-1.072 | −0.817 | −1.868-0.233 | ||||
| Months working as CHEW | ||||||||
| Less than 12 months | Ref. | Ref. | ||||||
| 12 or more | −0.418 | −1.301-0.466 | −0.395 | −1.270-0.480 | ||||
| Number of CUs covered | 0.177 | −0.320-0.674 | 0.172 | −0.320-0.665 | ||||
| CHEW satisfaction score | ||||||||
| Low | Ref. | Ref. | ||||||
| Middle | −0.835 | −1.856-0.185 | −0.811 | −1.822-0.120 | ||||
| High | −0.796 | −1.933-0.340 | −0.753 | −1.878-0.372 | ||||
| Social capital | ||||||||
| Low | Ref. | Ref. | ||||||
| Middle | −0.097 | −1.074-0.880 | −0.103 | −1.07-0.865 | ||||
| High | 0.485 | −0.540-1.510 | 0.469 | −0.546-1.485 | ||||
| Community education level | ||||||||
| Low | Ref. | Ref. | ||||||
| Middle | 0.135 | −0.732-1.001 | 0.130 | −0.727-0.988 | ||||
| High | 0.084 | −1.072-1.239 | 0.087 | −1.057-1.231 | ||||
| Community health knowledge status | ||||||||
| Low | Ref. | Ref. | ||||||
| Middle | 0.086 | −0.732-1.001 | 0.107 | −0.786-1.000 | ||||
| High | −0.184 | −1.072-1.239 | −0.183 | −1.243-0.877 | ||||
| Community wealth | ||||||||
| Low | Ref. | Ref. | ||||||
| Middle | 0.656 | −0.252-1.564 | 0.670 | −0.229-1.569 | ||||
| High | 0.973 | −0.399-2.345 | 0.974 | −0.384-2.333 | ||||
| Interaction | ||||||||
| (CHEWs’ knowledge and supervision) | ||||||||
| Low knowledge × Less than monthly | Ref. | |||||||
| Middle knowledge × Monthly | 0.473 | −0.237-1.184 | ||||||
| Middle knowledge × Frequent | 0.326 | −0.618-1.271 | ||||||
| High knowledge × Monthly | **1.140 | 0.488-1.791 | ||||||
| High knowledge × Frequent | *1.107 | 0.247-1.967 | ||||||
| ICC | 48.0 | 50.4 | 45.8 | 45.5 | ||||
| AIC | 4889 | 4780 | 4797 | 4793 | ||||
| Log Likelihood (Likelihood-ratio test) | −2441 | ***-2366 | -2360 | *-2354 | ||||
*< 0.05, **< 0.01, ***< 0.001