An assessment of attrition and retention of adherence support workers in Ndola district of Zambia

Abstract

Community health workers called Adherence Support Workers (ASWs) involved in antiretroviral therapy (ART) adherence management in Ndola district of Zambia are dropping out of work. For this reason this study sought insight into the factors determining attrition and retention of ASWs in Ndola district. It describes the characteristics of ASWs, including age, sex and marital status, and explores key factors influencing their attrition/retention, paying attention to reasons motivating their decision to become ASWs, the challenges they face in fulfilling their roles and their experience of training, supervision and support received. The study is descriptive in design and a quantitative survey which used semi-structured questionnaires to collect data from 35 active ASWs and 12 who had dropped out, and who were attached to 10 ART clinics and hospitals supported by the Zambia Prevention, Care and Treatment Partnership (ZPCT). Participants were recruited using purposive and snowball sampling techniques. Using the ZPCT data base, ASWs in the district were identified and approached at the facilities where they work. Those difficult to reach were traced through their colleagues (ASWs) and reached by telephone.