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UBC Theses and Dissertations

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UBC Theses and Dissertations

The recruitment and retention of community health workers in small cities, towns, and rural communities Sharman, Zena Catherine

Abstract

This study focused on the recruitment and retention of community health workers (CHWs) who work outside of large urban centres in small cities, towns, and rural communities in Canada. The study had three objectives: (1) to describe what CHWs working in small cities, towns, and rural communities have to say about their jobs, their working conditions, and their roles within the health care system; (2) to investigate these CHWs’ experiences of, and motivations for, pursuing a career in the home support sector; and (3) to develop recommendations to inform the design of policies and programs for the recruitment and retention of CHWs in small cities, towns, and rural communities. The study employed a qualitative research design informed by a feminist approach to health services research aimed at fostering “bottom-up” policy development informed by the perspectives of marginalized health care workers. The research process was carried out in partnership with a regional health authority in British Columbia, Canada. Data collection took place in four Vancouver Island communities: Campbell River, Parksville, Port Alberni and Port Hardy. Semi-structured interviews were conducted with 32 participants across the four study communities. The majority of the participants (n = 17) were unionized CHWs. The other respondents included nurses, managers, team leaders, and a scheduler. All interviews were transcribed and thematically analyzed. Study findings were later reported back to and validated by the participants. The study found that CHWs in the study communities performed a wide range of duties that extend beyond standard definitions of home support, of particular relevance to smaller communities with limited access to other health and social services. The primary facilitator of CHW recruitment and retention was the opportunity to build positive relationships with clients. Wages were the primary barrier to CHW recruitment and retention, in particular the wage disparity between community- and facility-based workers. Other barriers included the costs associated with paying for one’s own mobile phone and using one’s own vehicle on the job, CHWs’ unpredictable schedules, and feeling isolated from other members of the health care team.

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Attribution-NonCommercial-NoDerivatives 4.0 International