Effects of financial compensation structures on community health worker performance, motivation, and retention: evidence from a multi-arm quasi-experiment in Uganda.

ABSTRACT: Community Health Workers (CHWs) are central to extending primary health care in low-resource settings, yet their compensation remains a policy challenge. This paper reports findings from a five-arm quasi-experimental study conducted by Living Goods Uganda to test how different mixes of fixed stipends and performance-based incentives (PBIs) affect CHW performance, motivation, and retention. Over a nine-month period, 1,104 CHWs were assigned to five compensation models-70:30, 50:50, 30:70 PBI-to-stipend ratios, a 100% stipend arm, and a control-implemented across five districts. Quantitative data were analyzed using a difference-in-differences model with cluster-robust standard errors and wild-bootstrap inference, complemented by qualitative interviews and focus groups exploring experiences

SUBMITTER: Okech M 

PROVIDER: S-EPMC12738377 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature