The selection and training of primary health care workers in Ecuador: issues and alternatives for public policy

K R Mangelsdorf
International Journal of Health Services: Planning, Administration, Evaluation 1988, 18 (3): 471-93
This article employs quantitative analysis to evaluate the effectiveness of the community health worker (CHW) training program used by the Ministry of Public Health in Ecuador. The study first assesses CHW knowledge in the areas of prevention, maternal-child health, first aid, and treatment of common illnesses. The analysis reveals that CHWs retained less than 50 percent of what they learned one year after graduation. Demographic factors accounted for some variance in performance. Higher levels of community organization were associated with improved CHW knowledge. The presence of a health committee was also an important factor. The second phase of the study was designed to assess the community impact of the program. Surprisingly, neither the demographic characteristics of the health worker nor his or her level of competence affected the impact of the program on the community, as measured by patient satisfaction, utilization indices, and adoption of preventive health behaviors. It was the characteristics of the beneficiaries themselves that accounted for the variance in community impact. These results yield some important implications for public health policy in Ecuador.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"