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Table 3 Individual, Supervisor’s and Community factors associated with CHWs’ performance in Kisumu West, Siaya, Ugenya and Gem districts, Nyanza Province, Kenya

From: Individual and contextual factors associated with community health workers’ performance in Nyanza Province, Kenya: a multilevel analysis

  Model 0 Model 1 Model 2 Model 3
Individual variables Conf. 95 % CI. Conf. 95 % CI. Conf. 95 % CI. Conf. 95 % CI.
Gender  
 Female    Ref.   Ref   Ref.  
 Male    −0.157 −0.384-0.070 −0.155 −0.381-0.072 −0.132 −0.358-0.095
Age group (years)  
 <40    Ref.   Ref.   Ref.  
 ≥40    −0.176 −0.365-0.013 −0.174 −0.363-0.015 −0.158 −0.347-0.030
Marital status
 Single/Divorced/Widowed    Ref.   Ref.   Ref.  
 Married    0.732 −0.006-1.470 0.727 −0.011-1.465 *0.738 0.002-1.474
 Education level
No education/primary school dropout    Ref.   Ref.   Ref.  
 Primary level    ***0.654 0.395-0.913 ***0.655 0.396-0.914 ***0.651 0.393-0.909
 Secondary level or higher    ***0.934 0.679-1.190 ***0.933 0.678-1.189 ***0.928 0.674-1.183
Number of household members
 Fewer than 6    Ref.   Ref.   Ref.  
 6 or more    *0.201 0.014-0.388 *0.202 0.015-0.389 *0.199 0.013-0.386
Number of children under five
 Fewer than 1    Ref.   Ref.   Ref.  
 1 or more    −0.182 −0.386-0.022 −0.189 −0.394-0.015 −0.186 −0.390-0.017
Household wealth index
 Poorest    Ref.   Ref.   Ref.  
 Poorer    0.179 −0.094-0.452 0.180 −0.093-0.454 0.190 −0.082-0.463
 Middle    0.055 −0.225-0.335 0.053 −0.227-0.333 0.055 −0.224-0.335
 Richer    0.268 −0.034-0.564 0.261 −0.038-0.560 0.259 −0.039-0.557
 Richest    0.169 −0.125-0.463 0.167 −0.128-0.461 0.163 −0.129-0.457
Household sanitation practice
 Poor    Ref.   Ref.   Ref.  
 Middle    0.154 −0.131-0.439 0.150 −0.135-0.434 0.168 −0.117-0.452
 Good    ***0.580 0.304-0.856 ***0.583 0.307-0.860 ***0.616 0.340-0.331
Years working as CHWs
 Less than 4 years    Ref.   Ref.   Ref.  
 4 years or more    **0.339 0.129-0.549 *0.330 0.119-0.540 **0.327 0.118-0.537
Number of households covered
 Less than 21 households    Ref.   Ref.   Ref.  
 21 or more    0.159 −0.041-0.359 0.143 −0.058-0.345 0.131 −0.069-0.331
Job satisfaction
 Lowest    Ref.   Ref.   Ref.  
 Low    0.110 −0.164-0.384 0.113 −0.161-0.387 0.103 −0.171-0.378
 Middle    0.216 −0.066-0.498 0.218 −0.064-0.501 0.193 −0.089-0.475
 High    −0.011 −0.295-0.272 −0.010 −0.295-0.274 −0.034 −0.318-0.250
 Highest    −0.018 −0.300-0.264 −0.019 −0.301-0.264 −0.028 −0.310-0.255
Frequency of supervision received
 Less than monthly    Ref.   Ref.   Ref.  
 Monthly    −0.156 −0.437-0.124 −0.150 −0.431-0.130 ***−0.717 −1.191--0.242
 More frequently    ***−0.713 −1.083--0.344 ***−0.709 −1.079--0.340 ***−1.230 −1.863--0.597
Supervisor’s and community variables Conf. 95 % CI. Conf. 95 % CI. Conf. 95 % CI. Conf. 95 % CI.
CHEWs’ health knowledge
 Low      Ref.   Ref.  
 Middle      0.096 −1.113-1.305 −0.280 −1.614-1.053
 High      0.178 −0.717-1.072 −0.817 −1.868-0.233
Months working as CHEW
 Less than 12 months      Ref.   Ref.  
 12 or more      −0.418 −1.301-0.466 −0.395 −1.270-0.480
Number of CUs covered      0.177 −0.320-0.674 0.172 −0.320-0.665
CHEW satisfaction score
 Low      Ref.   Ref.  
 Middle      −0.835 −1.856-0.185 −0.811 −1.822-0.120
 High      −0.796 −1.933-0.340 −0.753 −1.878-0.372
Social capital
 Low      Ref.   Ref.  
 Middle      −0.097 −1.074-0.880 −0.103 −1.07-0.865
 High      0.485 −0.540-1.510 0.469 −0.546-1.485
Community education level
 Low      Ref.   Ref.  
 Middle      0.135 −0.732-1.001 0.130 −0.727-0.988
 High      0.084 −1.072-1.239 0.087 −1.057-1.231
Community health knowledge status
 Low      Ref.   Ref.  
 Middle      0.086 −0.732-1.001 0.107 −0.786-1.000
 High      −0.184 −1.072-1.239 −0.183 −1.243-0.877
Community wealth
 Low      Ref.   Ref.  
 Middle      0.656 −0.252-1.564 0.670 −0.229-1.569
 High      0.973 −0.399-2.345 0.974 −0.384-2.333
Interaction
(CHEWs’ knowledge and supervision)
 Low knowledge × Less than monthly        Ref.  
 Middle knowledge × Monthly        0.473 −0.237-1.184
 Middle knowledge × Frequent        0.326 −0.618-1.271
 High knowledge × Monthly        **1.140 0.488-1.791
 High knowledge × Frequent        *1.107 0.247-1.967
ICC 48.0   50.4    45.8    45.5  
AIC 4889   4780    4797    4793  
Log Likelihood (Likelihood-ratio test) −2441   ***-2366    -2360    *-2354  
  1. *< 0.05, **< 0.01, ***< 0.001