The amount and value of work time of community medicine distributors in community case management of malaria among children under five years in the Ejisu-Juaben District of Ghana

TY - JOUR

T1 - The amount and value of work time of community medicine distributors in community case management of malaria among children under five years in the Ejisu-Juaben District of Ghana

AU - Agyei-Baffour, Peter

AU - Hansen, Kristian Schultz

AU - Browne, Edmund N. L.

AU - Magnussen, Pascal

PY - 2012

Y1 - 2012

N2 - Background: The contribution of community medicine distributors (CMD) to prompt health service delivery in areas described as hard-to-reach is important but the value of their work time remains unknown and thus makes it difficult to design appropriate regular financial incentives to motivate them. This makes CMDs feel their efforts are not recognized. An attempt to estimate the value of 54 CMDs work time involved in community case management of malaria (CCMm) in a rural district in Ghana is presented. Methods. Time spent by CMDs on CCMm activities were recorded for a period of 12 months to determine the work-time value. Cost analysis was performed in Microsoft Excel with data from CMD records and at 2007 market price in Ghana. Results: A CMD spent 4.8 hours, [95% CI: 3.9; 5.3] on all CCMm-related activities per day. The time value of CMD work ranged from GH 2.04 (US$ 2.24) to GH 4.1 [US$ 4.6] per week and GH 19.2 - 86.4 (US$ 21.10-94.95) per month. The gross wage outside CCMm as reported by CMD was GH 58.4 [US$ 64.69] and value of foregone income of GH 86.40 (US$94.95) per month, about 14-times higher than the monthly incentives of GH 6.0 given by the CCMm programme. Conclusion: The value of work time and the foregone income of CMDs in CCMm are high and yet there are no regular and sustainable incentives provided for them. The results are significant to policy in designing incentives to motivate CMDs in large-scale implementation of CCMm.

AB - Background: The contribution of community medicine distributors (CMD) to prompt health service delivery in areas described as hard-to-reach is important but the value of their work time remains unknown and thus makes it difficult to design appropriate regular financial incentives to motivate them. This makes CMDs feel their efforts are not recognized. An attempt to estimate the value of 54 CMDs work time involved in community case management of malaria (CCMm) in a rural district in Ghana is presented. Methods. Time spent by CMDs on CCMm activities were recorded for a period of 12 months to determine the work-time value. Cost analysis was performed in Microsoft Excel with data from CMD records and at 2007 market price in Ghana. Results: A CMD spent 4.8 hours, [95% CI: 3.9; 5.3] on all CCMm-related activities per day. The time value of CMD work ranged from GH 2.04 (US$ 2.24) to GH 4.1 [US$ 4.6] per week and GH 19.2 - 86.4 (US$ 21.10-94.95) per month. The gross wage outside CCMm as reported by CMD was GH 58.4 [US$ 64.69] and value of foregone income of GH 86.40 (US$94.95) per month, about 14-times higher than the monthly incentives of GH 6.0 given by the CCMm programme. Conclusion: The value of work time and the foregone income of CMDs in CCMm are high and yet there are no regular and sustainable incentives provided for them. The results are significant to policy in designing incentives to motivate CMDs in large-scale implementation of CCMm.

KW - Former LIFE faculty

KW - Community case management

KW - Value of work time

KW - Community medicine distributors

KW - Malaria in children under five years

KW - Ghana

U2 - 10.1186/1475-2875-11-277

DO - 10.1186/1475-2875-11-277

M3 - Journal article

C2 - 22898097

SN - 1475-2875

VL - 11

JO - Malaria Journal

JF - Malaria Journal

IS - 277

ER -