Association between sociodemographic characteristics of female community health volunteers and their knowledge and performance on maternal and child health services in rural Nepal

Figures & data

Table 1 Knowledge and performance of FCHVs on MCH services according to sociodemographic characteristics

Characteristics	Knowledge of FCHV		OR (95% CI)	P-value	Performance of FCHV		OR (95% CI)	P-value
	Poor (n=66,%)	Good (n=72,%)			Unsatisfactory (n=88,%)	Satisfactory (n=50,%)
Age (years)
<35	21 (65.6)	11 (34.4)	1.00	0.048	27 (84.4)	5 (15.6)	1.00	0.002
35–45	26 (38.8)	41 (61.2)	3.0 (1.2–7.2)		33 (49.3)	25 (50.7)	5.5 (1.9–16.1)
>45	19 (48.7)	20 (51.3)	2.0 (0.7–5.2)		28 (71.8)	9 (28.2)	2.1 (0.6–6.9)
Educational level
Literate/primary	39 (73.6)	14 (26.4)	1.00	<0.001	47 (88.7)	6 (11.3)	1.00	<0.000
Secondary and above	27 (31.8)	58 (68.2)	5.9 (2.7–12.8)		41 (48.2)	44 (51.8)	8.4 (3.2–21.7)
Ethnicity/caste
Lower	19 (67.9)	9 (32.1)	1.00	0.043	18 (64.3)	10 (35.7)	1.00	0.975
Middle	29 (46.8)	33 (53.2)	2.4 (0.9–6.1)		40 (64.5)	22 (35.5)	0.9 (0.3–2.5)
Upper	18 (37.5)	30 (62.5)	3.5 (1.3–9.4)		30 (62.5)	18 (37.5)	1.0 (0.4–2.8)
Religion
Muslim/others	17 (58.6)	12 (41.4)	1.00	0.193	19 (65.5)	10 (34.5)	1.00	0.826
Hindu	49 (45.0)	60 (55.0)	1.7 (0.7–3.9)		69 (63.3)	40 (36.7)	1.1 (0.4–2.6)
Work experience
<10 years	33 (68.8)	15 (31.2)	1.00	<0.0001	34 (70.8)	14 (29.2)	1.00	0.209
≥10 years	33 (36.7)	57 (63.3)	3.8 (1.8–8.0)		54 (60.0)	36 (40.0)	1.6 (0.7–3.4)
Area of residence where MIRA working
No	52 (60.5)	34 (39.5)	1.00	<0.0001	67 (77.9)	19 (22.1)	1.00	,0.001
Yes	14 (26.9)	38 (73.1)	4.1 (1.9–8.7)		21 (40.4)	31 (59.6)	5.2 (2.4–11.0)
Total	66 (47.8)	72 (52.2)			88 (63.8)	50 (36.2)

Abbreviations: FCHV, female community health volunteer; MCH, maternal and child health; OR, odds ratio; CI, confidence interval; MIRA, Mother and Infant ResearchActivities.

Table 2 Multiple logistic regression model for knowledge and performance on MCHservice of FCHVs

Characteristics	Knowledge (adequate/inadequate), aOR (95% CI)	P-value	Performance (satisfactory/unsatisfactory), aOR (95% CI)	P-value
Age (years)
<35	1.00	0.133	1.00	0.007
35–45	0.9 (0.3–2.6)		5.4 (1.3–20.8)
>45	0.3 (0.1–1.1)		1.2 (0.2–5.1)
Educational level
Literate/primary	1.00	<0.0001	1.00	0.001
Secondary and above	5.5 (2.3–13.4)		6.6 (2.2–19.9)
Caste/ethnicity
Lower	1.00	0.053	1.00	0.456
Middle	3.2 (0.9–10.8)		1.4 (0.2–3.7)
Upper	2.5 (0.7–8.8)		0.5 (0.1–2.1)
Religion
Muslim/others	1.00	0.586	1.00	0.981
Hindu	1.3 (0.4–3.9)		0.9 (0.3–3.0)
Work experience
<10 years	1.00	0.012	1.00	0.786
≥10 years	3.1 (1.2–7.5)		0.8 (0.3–2.3)
Area of residence where MIRA working
No	1.00	0.002	1.00	,0.0001
Yes	4.2 (1.7–10.4)		8.3 (3.1–22.5)

Note: Variables entered: age group, literacy status, caste, religion, work experience, and place of residence in the working area of MIRA.

Abbreviations: MCH, maternal and child health; FCHV, female community health volunteer; aOR, adjusted odds ratio; CI, confidence interval; MIRA, Mother and Infant Research Activities.

Figure S1 Survey questionnaire.

Abbreviations: VDC, Village Development Committee; MCH, maternal and child health; FCHV, female community health volunteer.

Table

Section-1: Socio Demographic Details-I
Interviewer: “Now I would like to ask some questions about you”
QN	Questions	Coding categories	Remarks
1.	How old are you?	Age in completed year………….
2.	What is your caste or ethnicity?	1. □ Dalit Terai 2. □ Disadvantage Janajati Terai 3. □ Disadvantage non dalit tarai caste group 4. □ Religious minorities 5. □ Relatively advantaged Janajati 6. □ Upper caste group
3.	What is your religion?	1. □ Hindu 2. □ Muslim 3. □ Others…….
4.	What is the highesteducation level of…?	1. □ None 2. □ Primary/informal education 3. □ Lower secondary 4. □ Secondary level 5. □ Higher secondary 6. □ Intermediate and above
5	For how many years are you working as FCHV?	Experience in completed year………….
6	Are you residence of MIRA working area?	1. □ Yes 2. □ No

Section-2: Knowledge on MCH services
Interviewer: “Now I would like to ask some questions about your knowledge on MCH services”
QN	Questions	Coding categories			Go to Q.
	Please tell me regarding the following MCH services that should be taken by pregnant and postpartum mothers?	Yes	No	DK
11.	Minimum number of ANC visit recommended.	0	1	8
12.	Total number of IFA tablet to be consumed during pregnancy.	0	1	8
13.	Dose for TT immunization for pregnant	0	1	8
14.	Dose of De-worming for pregnant	0	1	8
15.	Is presence of SBA made delivery safe?	0	1	8
16.	Number of Postnatal visit recommended by GoN	0	1	8
17.	Number of Post partum Iron to be consumed.	0	1	8
18.	Dose of Vitamin A	0	1	8
19.	Number and time for Child Immunization	0	1	8
20.	Additional food intake required.	0	1	8

Section-3: Performance on MCH services
Interviewer: “Now I would like to ask some questions about your knowledge on MCH services”
QN	Questions	Coding categories			Go to Q.
	Please tell me regarding the following MCH services which you performed in last 6 months for pregnant and postpartum mothers	Yes	No	DK
21.	Create Community awareness to promote health and healthy behaviors.	0	1	8
22.	Counsel pregnant women on antenatal visit and postnatal visit.	0	1	8
33.	Counsel pregnant women for safe delivery (SBA/institutional delivery).	0	1	8
24.	Conduct regular mothers meeting.	0	1	8
25.	Counsel pregnant women for additional diet.	0	1	8
26.	Counsel postnatal mothers on breastfeeding, weaning and growth monitoring.	0	1	8
27.	Distribute condom, pills, ORS packets, and Vitamin A capsules.	0	1	8
28.	Mobilize mother and children for immunization.	0	1	8
29.	Refer complicated cases to health institution.	0	1	8
30.	Regular reporting of pregnancy to health facilities.	0	1	8

Abbreviations: MIRA, Mother and Infant Research Activities, IFA, iron and folic acid ; TT, tetanus toxoid; SBA, skilled birth attendants; GoN, Government of Nepal; ORS, oral rehydration salt; DK, do not know; ANC, antenatal care.