Capability, Community Participation and Factors Associated with the Abilities of Village Health Volunteers’ Community Health Management of Devolved Sub-District Health Promoting Hospitals of Provincial Administrative Organizations
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Abstract
This cross-sectional analytical study aimed to investigate the capability, community participation and factors associated with the abilities of village health volunteers (VHVs) in community health management of devolved sub-district health promoting hospitals of provincial administrative organizations (PAOs). The questionnaire survey included 3 dimensions: first, the capabilities of VHVs measured in 3 domains; knowledge, attitudes, and behavioral skills in community health management. Second, the participation and third, the capabilities of VHVs in community health management; all were measured based on self-assessed questionnaire. The content validity verified by three experts was of 0.85, 0.92, 0.95, 0.92, and 0.94, respectively. The study was conducted between March 2023 and February 2024. Sample selection employed a multi-stage random sampling method. This study recruited 482 VHVs from across 10 provinces of 4 regions. Data were analyzed using a computer program. Multiple logistic regression was used to analyze the data. Adjusted odds ratios (Adj.OR), 95% confidence intervals (95% CI), and p-values were reported. Results: Most of the participants were VHVs of medium-sized health promoting hospitals (52.9%), were female (82.0%), with age range of 50-59 years (38.6%). The average duration of being a VHV was 16.38 ± 9.64 years, and 87.3% had training experience. Capacity of VHVs in community health management comprised knowledge, attitudes, and behavioral skills in managing community health in five areas: health planning, leadership and budget management, organizing health promotion activities and disease prevention in the community, evaluating community health management, and information technology for managing community health. The findings showed that most VHVs had a high level of knowledge, attitude, and behavior in community health management. Specifically, VHVs demonstrated a high level of knowledge (mean 28.16, SD=1.79). They also showed a positive attitude (mean 4.37, SD=0.49). The highest average was found in organizing health promotion activities. The lowest was the evaluation of community health management. There was a high level of community health management behavior (mean 4.31, SD=0.50). The highest mean was found in information technology for community health management. The lowest were in organizing health promotion activities and controlling them, prevent disease in the community. The community participation of VHVs in community health management was at a high level (91.9%, mean 4.27, SD=0.57). A multiple logistic regression analysis was conducted to identify factors associated with VHVs’ ability to manage community health at a high level. The analysis revealed five significant factors: 1. skill potential, 2. participation, 3. age group, 4. the duration of being VHV, 5. occupation.
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