Lay worker attrition: important but often ignored
Open accessAbstract
Lay health workers are key to achieving universal health-care coverage, therefore measuring worker attrition and identifying its determinants should be an integral part of any lay health worker programme. Both published and unpublished research on lay health workers has largely focused on the types of interventions they can deliver effectively. This is an imperative since the main objective of these programmes is to improve health outcomes. However, high attrition rates can undermine the effectiveness of these programmes. There is a lack of research on lay health worker attrition. Research that aims to answer the following three key questions would help address this knowledge gap: what is the magnitude of attrition in programmes? What are the determinants of attrition? What are the most successful ways of reducing attrition? With community-based interventions and task shifting high on the United Nations Millennium Development Goals' policy agenda, research on lay health worker attrition and its determinants requires urgent attention.
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CHW turnover affects the sustainability of these care models and is understudied.
“Staff turnover of CHWs impacts sustainability of these models of care and remains understudied.65”
From Task-sharing approaches to improve mental health care in rural and other low-resource settings: a systematic review (2018) · cites this paper as [65]
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- Authors
- Nkonki, L., Cliff, J., & Sanders, D.
- Affiliations
- South African Medical Research Council (ZA)
- Eduardo Mondlane University (MZ)
- University of the Western Cape (ZA)
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2011-12-01
- Volume
- 89
- Issue
- 12
- Pages
- 919-923
- ISSN
- 0042-9686 (ISSN-L)
- PMC
- PMC3260896
- OpenAlex
- W2131648747
- Cited by
- 103
- References
- 25
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 7 · 2022: 11 · 2021: 8 · 2020: 9 · 2019: 8 · 2018: 10 · 2017: 9 · 2016: 8 · 2015: 15 · 2014: 6 · 2013: 6
- FWCI
- 5.99
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Bulletin of the World Health Organization (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Instituut voor Tropische Geneeskunde
- Universiteit Stellenbosch
- Universitetet i Bergen
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
- Keywords
- lay health workers, community-based intervention, task shifting, universal health coverage, health workforce retention
- MeSH terms
- Workforce, Delivery of Health Care, Health Personnel, Humans, Job Satisfaction, Motivation, Personnel Turnover, Global Health, Universal Health Insurance
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