Abstract
Nepal female community health volunteers (FCHVs) were the first available health personnel in communities during the 2015 Nepal earthquakes. This study explored the facilitating factors and barriers of the FCHVs during health emergencies. In-depth interviews with 24 FCHVs and 4 health managers from 2 districts in Nepal (Gorkha and Sindhupalchowk) were conducted using semi-structured interview guides. The qualitative data were analyzed using thematic analysis methods. FCHVs were the first responders to provide services after the earthquakes and were well accepted by the local communities. Different models of supervision existed, and differences in the workload and remuneration offered to FCHVs were described. A wide range of disaster-related knowledge and skills were required by FCHVs, and lack of prior training was an issue for some respondents. Furthermore, lack of access to adequate medical supplies was a major barrier for FCHVs in the 2015 earthquakes. The 5 identified themes were discussed. Providing regular disaster response training for FCHVs and strong leadership from the public sector with sustained investments will be essential for increasing the capacities of community health workforces to prepare for and reduce the impacts of future health emergencies in resource-poor settings.
Highlights
MethodsThis qualitative study used semi-structured in-depth interviews with 24 female community health volunteers (FCHVs) and 4 health managers to explore their experiences during the 2015 earthquakes through open-ended questions
This report constitutes 1 of the case studies in a World Health Organization (WHO) -funded research project “Health workforce development strategy in Health EDRM: evidence from literature review, case studies and expert consultations”.16. This qualitative study used semi-structured in-depth interviews with 24 female community health volunteers (FCHVs) and 4 health managers to explore their experiences during the 2015 earthquakes through open-ended questions
Less than half of the FCHVs had worked for over 20 y, and the majority served over 100 households
Summary
This qualitative study used semi-structured in-depth interviews with 24 FCHVs and 4 health managers to explore their experiences during the 2015 earthquakes through open-ended questions. FCHVs were selected purposively: (1) FCHVs who worked during and after the 2015 earthquake in these districts: and (2) FCHVs who continued to work at the time of the study. The WHO situation report identified 14 districts as severely affected by the earthquakes.[17]. Gorkha and Sindhupalchock, were selected as Gorkha was the epicenter of the earthquakes and Sindhupalchock had the highest death rate.[18,19]. Both districts had the highest economic disaster effects per person (average values > NPR [Nepalese Rupee] 130,000 per person ≈ USD 1115) (Figure 1).[20]. A brief profile of the districts is included in the supplementary file
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