Table 2 Non-salary incentives for CHWs

Assistance with the formation or functioning of CHW groups

In a number of countries, national CHW programmes assist CHWs with the formation of local groups of CHWs which can serve a variety of different purposes. In Rwanda, CHW cooperatives have been established. These cooperatives receive funds directly from the government for the services of its members, and the members work together using these funds as seed money for other income-generating activities [42]. In Madagascar, CHWs have access to savings and lending groups and insurance groups [44]. In Nepal, female community health volunteers have access to microcredit groups and loans. In Nepal, the government has also established local endowment funds for local endowment funds for FCHVS throughout the country. Female community health volunteers are able to draw loans to pursue income-generating activities or receive small payments for their work [45]

Supplies and equipment required for the work

Having the needed supplies and equipment are the basis for good performance, of course, but unfortunately, CHWs are often lacking essentials. Having what is needed is a source of affirmation and motivation. Examples of such items that programmes provide include uniforms, identification badges, T-shirts, hats, all-weather boots, backpacks, bicycles, start-up kits of supplies, flashlights, thermometers, and stopwatches (to measure respiratory rate). Occasionally, gasoline is provided as in the case of community health services supervisors in Liberia [46]

Per diem payments for work

In many CHW programmes, particularly for those that use volunteers or for programmes that are funded by disease-control programmes, CHWs receive a per diem payment to participate in special campaigns for community mobilization activities, such as immunization days, child health days, and so forth

Job-related nonfinancial benefits

In Afghanistan and Ghana, communities assist with housing for CHWs or with the construction of a health post as an extension of the house [47, 48]. In Indonesia, Kaders, who are volunteers, receive free medical care from higher levels of the health system [49]. Per diem payments for trainings are often attractive to CHWs since they not uncommonly provide some additional income beyond the actual costs involved in attending a training

Career advancement

Opportunities for career advancement and further educational opportunities are highly valued by CHWs. In some cases (e.g., in Ethiopia), a health extension worker can advance to a higher pay grade after obtaining further in-service training, though they continue in their same role as before. They can also receive preferential consideration when applying to enter a training programme for a high-level health worker position [50]. In some programmes, CHWs can advance to a CHW supervisory position (as in Madagascar, Malawi, and Sierra Leone). Ghana provides its community health officers with paid educational leave

Public recognition for service

Many programmes give CHWs, especially those who volunteer, certificates or other forms of special recognition. Communities often provide recognition as well, including community labour to assist CHWs with their agricultural or construction work. Thailand provides its CHW volunteers with leisure activities, parties, and field trips [38]. Cash prizes for high performance are provided in Afghanistan [47]. In Niger, communities provide their Relais volunteers with gifts of produce from their crops [51]