title: Provider and service-user perspectives of volunteer health-worker service provision in Ayeyarwady Region, Myanmar: a qualitative study.
abstract: To explore perspectives and reported experiences of service users, community providers and policymakers related to volunteer health-worker services provision in a rural area of Myanmar.
  
  
  
  A qualitative interview study was conducted in rural communities with 54 service users and 17 community providers in Ayeyarwady Region, Myanmar, and with 14 national managers and policymakers in Yangon Myanmar. Topics included reasons for seeking health services, views and experiences, and comparison with experiences of other services. Data were analysed thematically using deductive and inductive coding.
  
  
  
  Accessibility and affordability were important to all participants. Service users described the particular relevance of trust, familiarity and acceptability in choosing a provider. Perceived quality and effectiveness were necessary for trust to develop. Perceived value of volunteers was a cross-cutting dimension, which was interpreted differently by different participants.
  
  
  
  Results suggest that volunteers are appropriate and valued, and support 'availability', 'accessibility' and 'acceptability' as dimensions of health services access in this setting. However, social complexities should be considered to ensure effective service delivery. Further research into trust-building, developing quality perceptions and resulting service-user choices would be useful to inform effective policy and planning.
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Watt
authors.affiliation: Formerly Merlin Country Office, Yangon, Myanmar.|PR-GFATM, UNOPS, Yangon, Myanmar.
authors.forename: Aye
authors.initials: A
authors.lastname: Yupar
authors.affiliation: Formerly Merlin Country Office, Yangon, Myanmar.|PR-GFATM, UNOPS, Yangon, Myanmar.
authors.forename: Paul
authors.initials: P
authors.lastname: Sender
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.|Formerly Merlin Country Office, Yangon, Myanmar.
authors.forename: Fiona
authors.initials: F
authors.lastname: Campbell
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Helena
authors.initials: H
authors.lastname: Legido-Quigley
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Natasha
authors.identifier: 0000-0003-4174-7349
authors.initials: N
authors.lastname: Howard
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003150:Community Health Workers; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D002052:Myanmar; D017060:Patient Satisfaction; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D014838:Volunteers
keywords: PRIMARY CARE; QUALITATIVE RESEARCH