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Tytuł:
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A time motion study of community mental health workers in rural India.
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Autorzy:
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Chebolu-Subramanian V; IFMR Graduate School of Business, KREA University, 5655, Central Expressway, Sri City, Andhra Pradesh, 517646, India. .
Sule N; Foundation for Research in Community Health, 3-4, Trimiti-B Apartments, Anand Park, Aundh, Pune, Maharashtra, 411007, India.
Sharma R; Foundation for Research in Community Health, 3-4, Trimiti-B Apartments, Anand Park, Aundh, Pune, Maharashtra, 411007, India.
Mistry N; Foundation for Research in Community Health, 3-4, Trimiti-B Apartments, Anand Park, Aundh, Pune, Maharashtra, 411007, India.
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Źródło:
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BMC health services research [BMC Health Serv Res] 2019 Nov 21; Vol. 19 (1), pp. 878. Date of Electronic Publication: 2019 Nov 21.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001-
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MeSH Terms:
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Community Health Workers*
Time and Motion Studies*
Community Health Services/*organization & administration
Home Care Services/*organization & administration
Mental Health Services/*organization & administration
House Calls/statistics & numerical data ; Humans ; India ; Rural Health Services/organization & administration ; Workflow
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References:
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Grant Information:
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000 Jamsetji Tata Trust, Mumbai through Parivartan Trust, Satara, India.
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Contributed Indexing:
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Keywords: Community health workers; Mental health program; Time motion study; Value stream mapping; Work flow
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Entry Date(s):
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Date Created: 20191123 Date Completed: 20200228 Latest Revision: 20200228
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Update Code:
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20240104
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PubMed Central ID:
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PMC6873675
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DOI:
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10.1186/s12913-019-4732-7
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PMID:
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31752869
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Background: Community Health Workers (CHWs) are critical to providing healthcare services in countries such as India which face a severe shortage of skilled healthcare personnel especially in rural areas. The aim of this study is to understand the work flow of CHWs in a rural Community Mental Health Project (CMHP) in India and identify inefficiencies which impede their service delivery. This will aid in formulating a targeted policy approach, improving efficiency and supporting appropriate work allocation as the roles and responsibilities of the CHWs evolve.
Methods: A continuous observation Time Motion study was conducted on Community Health Workers selected through purposive sampling. The CHWs were observed for the duration of an entire working day (9 am- 3 pm) for 5 days each, staggered during a period of 1 month. The 14 different activities performed by the CHWs were identified and the time duration was recorded. Activities were then classified as value added, non-value added but necessary and non-value-added to determine their time allocation.
Results: Home visits occupied the CHWs for the maximum number of hours followed by Documentation, and Traveling. Documentation, Administrative work and Review of work process are the non-value-added but necessary activities which consumed a significant proportion of their time. The CHWs spent approximately 40% of their time on value added, 58.5% of their time on non-value added but necessary and 1.5% of their time on non-value added activities. The CHWs worked for 0.7 h beyond the stipulated time daily.
Conclusion: The CHW's are "dedicated" mental health workers as opposed to being "generalists" and their activities involve a significant investment of their time due to the specialized nature of the services offered such as counselling, screening and home visits. The CHWs are stretched beyond their standard work hours. Non-value added but necessary activities consumed a significant proportion of their time at the expense of value-added activities. Work flow redesign and implementation of Health Management Information Systems (HMIS) can mitigate inefficiencies.
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