title: Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation.
abstract: OBJECTIVE
  This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda.
  
  
  METHODS
  Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive.
  
  
  RESULTS
  We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community.
  
  
  CONCLUSIONS
  A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers.
authors.affiliation: EHESP Rennes, Sorbonne Paris Cité, France CNRS, UMR CRAPE Centre de Recherches sur l'Action Politique en Europe, Rennes, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Vareilles
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Bruno
authors.initials: B
authors.lastname: Marchal
authors.affiliation: Department of Development, Policy and Practice, Royal Tropical Institute, Amsterdam, The Netherlands.
authors.forename: Sumit
authors.initials: S
authors.lastname: Kane
authors.affiliation: Department of Community Health and Innovation, International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland.
authors.forename: Taja
authors.initials: T
authors.lastname: Petrič
authors.affiliation: Department of Community Health and Innovation, International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Pictet
authors.affiliation: EHESP Rennes, Sorbonne Paris Cité, France CNRS, UMR CRAPE Centre de Recherches sur l'Action Politique en Europe, Rennes, France.
authors.forename: Jeanine
authors.initials: J
authors.lastname: Pommier
mesh_terms: D057191:Capacity Building / Q000458:organization & administration*; D003150:Community Health Workers / Q000523:psychology*; D005260:Female; D006801:Humans; D017589:Immunization Programs; D008297:Male; D009042:Motivation; D015397:Program Evaluation; D011634:Public Health; D036301:Qualitative Research; D012011:Red Cross / Q000458:organization & administration*; D014454:Uganda; D014838:Volunteers / Q000523:psychology*
keywords: PUBLIC HEALTH