Factors Associated with Dropout Among Community Health Workers in Musanze District, Rwanda: A Cross Sectional Study

Abstract

INTRODUCTION: Dropout has been renowned as one of the main challenges of Community Health Workers (CHWs) programs in addition to the health facilities. This has got a serious public health implication as it can hinder the increase of health service delivery in rural and urban areas. This study aimed to determine the factors associated with dropout among CHWs in Musanze District, Rwanda. METHODS: A descriptive cross-sectional study was conducted. Three sectors from the district were selected purposively with a total sample size of 252 CHWs who were elected and recruited in 2013. Data was collected using semi-structured questionnaire and was analysed using SPSS version 25. Multiple logistic regression analysis was performed to determine the independent factors associated with dropout of CHWs. RESULTS: Out of the total (252 CHWs) enrolled since 2013, about 10% had left the health system in a period of 4 years. Following the multiple logistic regression analysis; being single [AOR=2.58, 95%CI=1.09-6.93], engaged in business [AOR=3.22, 95%CI=1.25-8.27] and relationship with supervisors [AOR=0.25, 95%CI=0.09-0.67] were independently associated with dropout of CHWs. CONCLUSION: Dropout rate during the period of four years was 9.9%. Marital status and occupation are main factors affecting dropout of CHWs in Musanze district.