I just want to stress one point in the equation on how to support CHWs so that they can be successful - the debate about whether CHWs should be paid. Some say that we have to pay them because it is morally right to do so, and it allows them to work harder. Others say it is bad to pay them because payment may "kill the spirit of volunteerism.” The following ideas inform my own thinking on this, and I wanted to share them to get your thoughts:
• Time is money; money is time – if you want CHWs to work regular and long hours, you have to pay them because this money enables them to focus on this work instead of other work. By paying them you are buying the time they would be spending otherwise on their work that puts food on the table. Making their CHW job a livelihood sets the stage for effective contributions.
• Money is not (only) motivation – a salary enables, but so much more is needed to motivate. There are many models available from the business literature on what contributes to a robust motivation, but most will describe the importance of factors such as job design, the organization’s work culture, supporting supervision and mentoring, etc. When working to build a job that CHW love to do, ask whether the job offers them some measure of autonomy, mastery, and purpose. The 360 supervision structures described by the Muso team in another conversation goes a long way in this direction.
• CHWs are human – CHWs will respond to opportunities in ways that are very similar to how you or I would respond: they will weigh the options, assess the risks and benefits, and lean towards what makes the most sense in their lives. Many programs look to “non-monetary incentives” as the primary "motivator," but while bicycles, umbrellas, t-shirts, and gumboots are all great work tools, are they sufficient alone to make a CHW work every day with excellence and fidelity? The ability to grow in their work, make extra money in “moonlighting” opportunities, grow in their standing in the community – these are some of the elements that may lead to that extra spark that distinguishes barely functional CHW programs from those that are truly exceptional.