Staff attrition among community health workers in home-based care programmes for people living with HIV and AIDS in western Kenya

Health Policy. 2010 Oct;97(2-3):232-7. doi: 10.1016/j.healthpol.2010.05.004. Epub 2010 Jun 8.


Objectives: This paper examines trends and underlying causes of attrition among volunteer community health workers in home-based care for people living with HIV and AIDS in western Kenya.

Methods: Ethnographic data were collected between January and November 2006 through participant observation, focus group discussions and in-depth interviews with 30 CHWs, NGO staff and health care providers and 70 PLWHA.

Results: An attrition rate of 33% was observed among the CHWs. The reasons for dropout included: the cultural environment within which CHWs operated; lack of adequate support from area NGOs; poor selection criteria for CHWs; and power differences between NGO officials and CHWs which fostered lack of transparency in the NGOs' operations.

Conclusions: In order to achieve well functioning and sustainable HBC services, factors which influence retention/dropout of CHWs should be addressed taking into account the socio-cultural, programmatic and economic contexts within which CHW activities are implemented.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Community Health Workers / supply & distribution*
  • Female
  • Focus Groups
  • HIV Infections / therapy*
  • Health Policy
  • Home Care Services* / organization & administration
  • Humans
  • Kenya
  • Male
  • Personnel Selection
  • Social Support
  • Volunteers*
  • Workforce