title: Village health volunteers' social capital related to their performance in Lao People's Democratic Republic: a cross-sectional study.
abstract: BACKGROUND
  Improving the performance of community health workers (CHWs) is a global issue. The relationship between CHWs and their community may impact their performance. In Lao People's Democratic Republic (Lao PDR), CHW are called village health volunteers (VHV). Lao PDR has a problem with VHV inactivity, especially in rural areas. This study focused on which aspects of social capital are related to VHV performance.
  
  
  METHODS
  This research represents a cross-sectional study with a quantitative survey based primarily on interviews using a semi-structured questionnaire. Interviews were conducted with 149 VHVs living and working in the Sepon District. VHV performance evaluation was measured with scores on a 5-point scale, and the cutoff point for designating performance as good or poor was set at the median score. This evaluation of VHV performance was conducted as a self-evaluation by VHVs and by health center staff who were supervisors of the VHVs. Measurement of social capital was accomplished using the short version of the Adapted Social Capital Assessment Tool (SASCAT). For statistical analyses, logistic regression was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  The results of multiple logistic regression adjusted by moderator variables showed that citizenship activities in the structural social capital component of SASCAT were significantly related to performance in self-evaluation by VHVs (adjusted OR: 2.10, 95% CI: 1.19-3.71) and the evaluations by health center staff (adjusted OR: 1.67, 95% CI: 1.01-2.77). Support from groups (adjusted OR: 1.87, 95% CI: 1.27-2.76) and cognitive social capital (adjusted OR: 7.48, 95% CI: 2.14-26.10) were found to be significantly associated but only for VHV self-evaluation.
  
  
  CONCLUSIONS
  The results suggest that individuals who interact with important figures in the community and who cooperate with other villagers whenever problems arise, i.e., have social capital, exhibit good performance as VHVs. These findings suggest that increasing citizenship activities could increase the retention rate of CHWs and help improve their performance. Citizenship activities could also be used as a predictive indicator when selecting new CHWs.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sato
authors.forename: Tiengkham
authors.initials: T
authors.lastname: Pongvongsa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nonaka
authors.forename: Sengchanh
authors.initials: S
authors.lastname: Kounnavong
authors.forename: Phetsomphone
authors.initials: P
authors.lastname: Nansounthavong
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Moji
authors.forename: Panom
authors.initials: P
authors.lastname: Phongmany
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kamiya
authors.forename: Miho
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Global Health, School of Health Sciences, University of the Ryukyus, Okinawa, Japan. junkobalao@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D000328:Adult; D003150:Community Health Workers / Q000458:organization & administration / Q000592:standards*; D003430:Cross-Sectional Studies; D006801:Humans; D007407:Interviews as Topic; D007812:Laos / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult