%0 Journal Article
%T Translating Community Connectedness to Practice: A Qualitative Study of Midlevel Health Workers in Rural Guatemala
%A Alison Hern¨˘ndez
%A Anna-Karin Hurtig
%A Kjerstin Dahlblom
%A Miguel San Sebasti¨˘n
%J ISRN Nursing
%D 2012
%R 10.5402/2012/648769
%X Background. The performance of midlevel health workers is a critical lever for strengthening health systems and redressing inequalities in underserved areas. Auxiliary nurses form the largest cadre of health workers in Guatemala. In rural settings, they provide essential services to vulnerable communities, and thus have great potential to address priority health needs. This paper examines auxiliary nursesĄŻ motivation and satisfaction, and the coping strategies they use to respond to challenges they confront in their practice. Methods. Semistructured interviews were conducted with 14 auxiliary nurses delivering health services in Alta Verapaz, Guatemala. Results. Community connectedness was central to motivation in this rural Guatemalan setting. Participants were from rural communities and conveyed a sense of connection to the people they were serving through shared culture and their own experiences of health needs. Satisfaction was derived through recognition from the community and a sense of valuing their work. Auxiliary nurses described challenges commonly faced in low-resource settings. Findings indicated they were actively confronting these challenges through their own initiative. Conclusions. Strategies to support the performance of midlevel health workers should focus on mechanisms to make training accessible to rural residents, support problem-solving in practice, and emphasize building relationships with communities served. 1. Background Midlevel health workers (MLHWs) are the mainstay of health service delivery in many low income countries. Given their prominent role, supporting the performance of MLHWs is a critical lever for strengthening health systems and redressing health inequalities in underserved areas. MLHWs are defined as health care providers with formal accreditation but shorter training and a more restricted scope of practice than professionals [1]. MLHW cadres share characteristics that make them particularly attractive for initiatives to improve access to care and mitigate health workforce deficits [2, 3]. Lower entry level education requirements make it easier to recruit locals who have potential to provide more culturally and linguistically appropriate care and may be easier to retain in rural placements [4]. Studies indicate that with adequate training and continued support, MLHWs can provide care comparable to professionals [5]. Increasing deployment of MLHWs can also be appealing as a lower cost alternative for improving coverage. Despite their centrality in the health workforce, MLHW cadres tend to have low status and
%U http://www.hindawi.com/journals/isrn.nursing/2012/648769/