title: Association between sociodemographic characteristics of female community health volunteers and their knowledge and performance on maternal and child health services in rural Nepal.
abstract: BACKGROUND
  Engaging community health volunteers and community health workers to provide maternal and child health (MCH) care services in resource-poor settings is one of the global and widely used concepts. Despite a great role of female community health volunteers (FCHVs) in MCH services in Nepal, few research studies have been performed in this area. Our research aimed to assess the knowledge and performance of FCHVs on MCH services associated with their sociodemographic characteristics.
  
  
  METHODS
  A cross-sectional survey was conducted to assess the knowledge and performance on selected MCH services of FCHVs using structured questionnaire in 16 village development committees of Dhanusha district, Southern Terai, Nepal, from the first of January to the end of February of 2014. A total of 138 FCHVs were selected by using multistage random sampling technique. Logistic regression was employed to examine the association between selected sociodemographic characteristics and knowledge and performance on MCH services of FCHVs after adjusting for significant variables associated with knowledge and performance and within-cluster effect.
  
  
  RESULTS
  Our findings demonstrated that sociodemographic characteristics were associated independently with good knowledge of FCHVs on MCH services: education level secondary and above (adjusted odds ratio [aOR] 5.2; 95% confidence interval [CI] 2.2-12.2); residing in Mother and Infant Research Activities, nongovernmental organization working area (aOR 3.7; 95% CI 1.5-8.8); and middle caste (aOR 3.3; 95% CI 1.0-10.3). Similarly, satisfactory performance of FCHVs significantly associated with MCH services were education level secondary and above (aOR 8.9; 95% CI 3.2-24.3) and residing in Mother and Infant Research Activities working areas (aOR 9.0; 95% CI 3.5-22.6).
  
  
  CONCLUSIONS
  The study recommends considering education level while recruiting rural FCHVs and capacity enhancement through additional training and development programs in collaboration with developmental partner.
authors.affiliation: Department of Community Medicine, Kathmandu University, Devdaha Medical College and Research Institute, Devdaha-10, Rupandehi, Nepal; Department of Public Health, Purbanchal University, Sanjeevani College of Medical Sciences, Butwal, Rupandehi, Nepal.
authors.forename: Dilaram
authors.initials: D
authors.lastname: Acharya
authors.affiliation: Department of Community Medicine and Public Health, Janaki Medical College, Tribhuvan University, Janakpur, Nepal; Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, India.
authors.forename: Jitendra Kumar
authors.initials: JK
authors.lastname: Singh
authors.affiliation: Institute of Medicine, Maharajgunj Medical Campus,Tribhuvan University, Kathmandu, Nepal.
authors.forename: Samaj
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Sam Higginbottom Institute of Agriculture,Technology and Sciences, Allahabad, India.
authors.forename: Varidmala
authors.initials: V
authors.lastname: Jain
keywords: FCHV; Nepal; knowledge; performance; sociodemographic characteristics