title: Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation protocol.
abstract: BACKGROUND
  The recruitment of community health volunteers to support the delivery of health programmes is a well-established approach in many countries, particularly where health services are not readily available. However, studies on management of volunteers are scarce and current research on human resource management of volunteers faces methodological challenges. This paper presents the protocol of a realist evaluation that aims at identifying the factors influencing the performance of community health volunteers involved in the delivery of a Red Cross immunisation programme in Kampala (Uganda) with a specific focus on motivation.
  
  
  METHODS
  The realist evaluation cycle structures the protocol. To develop the theoretical basis for the evaluation, the authors conducted interviews and reviewed the literature on community health volunteers' performance, management and organisational behaviour. This led to the formulation of the initial programme theory, which links the intervention inputs (capacity-building strategies) to the expected outcomes (positive work behaviour) with mechanisms that point in the direction of drivers of motivation. The contextual elements include components such as organisational culture, resource availability, etc. A case study design will be adopted. We define a case as a Red Cross branch, run by a programme manager, and will select two cases at the district level in Kampala. Mixed methods will be used in data collection, including individual interviews of volunteers, participant observation and document review. The thematic analysis will be based on the initial programme theory and will seek for context-mechanism-outcome configurations. Findings from the two cases will be compared.
  
  
  CONCLUSIONS
  We discuss the scope for applying realist evaluation and the methodological challenges we encountered in developing this protocol.
  
  
  BACKGROUND
  The study was approved by the Ethical Committee at Rennes University Hospital, France. Results will be published in scientific journals, and communicated to respondents and relevant institutions.
authors: EHESP Rennes, Sorbonne Paris Cité, Rennes, France CNRS, UMR CRAPE Centre de Recherches sur l'Action Politique en Europe-6051, Rennes, France.
authors: Gaëlle
authors: G
authors: Vareilles
authors: EHESP Rennes, Sorbonne Paris Cité, Rennes, France CNRS, UMR CRAPE Centre de Recherches sur l'Action Politique en Europe-6051, Rennes, France.
authors: Jeanine
authors: J
authors: Pommier
authors: Department of Development, Policy and Practice, Royal Tropical Institute, Amsterdam, The Netherlands.
authors: Sumit
authors: S
authors: Kane
authors: International Federation of Red Cross and Red Crescent Societies, Community Health and Innovation, Geneva, Switzerland.
authors: Gabriel
authors: G
authors: Pictet
authors: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Bruno
authors: B
authors: Marchal
mesh_terms: D057191:Capacity Building; D003153:Community Health Services / Q000592:standards*; D003150:Community Health Workers; D003625:Data Collection; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D017589:Immunization Programs; D008297:Male; D009042:Motivation; D011361:Professional Competence; D015397:Program Evaluation; D011634:Public Health; D012107:Research Design; D014454:Uganda; D014838:Volunteers
keywords: PUBLIC HEALTH
references: JAMA. 2008 Mar 12;299(10):1182-4
references: 18334694
references: Cochrane Database Syst Rev. 2010 Nov 10;(11):CD007754
references: 21069697
references: Hum Resour Health. 2009 Apr 09;7:31
references: 19358701
references: J Health Serv Res Policy. 2005 Jul;10 Suppl 1:21-34
references: 16053581
references: Lancet. 2007 Jun 23;369(9579):2121-31
references: 17586307
references: Hum Resour Health. 2010 Mar 31;8:8
references: 20356363
references: BMC Health Serv Res. 2010 Jan 25;10:24
references: 20100330
references: Psychol Rev. 1959 Sep;66:297-333
references: 13844397
references: BMC Health Serv Res. 2012 Jul 09;12:194
references: 22776682
references: Trans R Soc Trop Med Hyg. 2009 Jun;103(6):549-58
references: 18992905
references: Int J Health Plann Manage. 2004 Oct-Dec;19(4):337-64
references: 15688877
references: BMC Health Serv Res. 2013 Nov 08;13:469
references: 24209295
references: Health Promot Int. 2011 Jun;26(2):177-87
references: 20819830
references: Health Promot Int. 2006 Dec;21 Suppl 1:75-83
references: 17307960
references: Bull World Health Organ. 2011 Dec 1;89(12):919-23
references: 22271950
references: BMJ. 2008 Sep 29;337:a1655
references: 18824488
references: J Pers Soc Psychol. 1998 Jun;74(6):1516-30
references: 9654757
references: J Appl Psychol. 2001 Dec;86(6):1294-9
references: 11768070
references: Lancet. 2005 Sep 17-23;366(9490):1026-35
references: 16168785
references: AIDS. 2010 Jan;24 Suppl 1:S45-57
references: 20023439
references: Am J Public Health. 2006 Mar;96(3):505-14
references: 16449579
references: Cochrane Database Syst Rev. 2010 Mar 17;(3):CD004015
references: 20238326