Human resource challenges in community health surveys: insights from a national household survey in India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20262273Keywords:
Community health worker, Data collection, Malaria, Personal management, Health surveysAbstract
Background: India with geographically diverse and malaria-endemic regions, extensive community health survey becomes essential to generate critical data for public health planning. However, their success completely relies on the team efforts of field data collectors working across socially heterogenous settings, and the institutional teams for recruiting, training and retaining the workforce. Moreover, both field workforce and recruiters face major operational, logistical, and supervisory demands while implementing such high-volume household surveys across remote terrain, dispersed settlements, and culturally diverse communities. However, the effectiveness of these human resource systems working under real-world complex conditions ultimately becomes the strength of these large-scale surveys as it requires to navigate field realities challenges while maintain the workforce retention, protocol adherence, and high data quality at this scale.
Methods: A cross-sectional descriptive study was conducted among the staffs working in the multi-state Indian Council of Medical Research-National Institute of Malaria Research (ICMR-NIMR) Household Survey Project surveying 37849 households across diverse geographic settings in India. Structured and pre-tested questionnaire was used to collect data. Descriptive statistics were used to summarise the key findings.
Results: Across multiple malaria-endemic states, 23 field data collectors were deployed with high level of training coverage, supervision and team cohesion. Although there was extended working hours and logistical demands, 78.3% reported to complete their full contract tenure reflecting the workforce stability and strong retention.
Conclusions: Overall findings suggest that in geographically and operationally complex setting with large population of 37849 households, structured human resource systems effectively sustained motivation, performance and data collection quality.
References
Zodpey S, Negandhi H, Tiwari R. Human resources for health in India: strategic options for transforming health systems towards improving health service delivery and public health. J Heal Manag. 2021;23(1):31-46.
Garg S, Tripathi N, McIsaac M, Zurn P, Zapata T, Mairembam DS, et al. Implementing a health labour market analysis to address health workforce gaps in a rural region of India. Hum Resour Health. 2022;20(1):50.
Liverpool School of Tropical Medicine. Policy and practice of human resource management in the Indian public health system at district level and its effects on health workers. Available at: https://research.lstmed.ac.uk/en/studentTheses/policy-and-practice-of-human-resource-management-in-the-indian-pu-18/. Accessed 19 February 2026.
Nair KS. Health workforce in India: opportunities and challenges. Int J Commu Medi Publ Heal. 2019;6(10):4596-604.
Jeevitha G. Health workforce status in India: A qualitative analysis of parliamentary questions documented in the last two decades. J Fam Med Prim Care. 2025;14(6):2351-7.
Mehta V, Ajmera P, Kalra S, Miraj M, Gallani R, Shaik RA, et al. Human resource shortage in India’s health sector: a scoping review of the current landscape. BMC Publ Heal. 2024;24(1):1368.
Sinha P, Sigamani P. Key challenges of human resources for health in India. Global J Medi Publ Heal. 2016;5(4):1-0.
Aruldas K, Janagaraj V, Alagesan A, Balakrishnan A, Vasudevan G, Ajjampur SSR. Field experiences: conducting one health surveys to determine transmission risks from poultry in markets and farms in southern India. Ind J Publ Heal. 2025;69(3):344.
Green-Hernandez C. Transportation challenges in rural healthcare. Nurse Pract. 2006;31(12):10.
Gopalakrishnan L, Diamond-Smith N, Avula R, Menon P, Fernald L, Walker D, et al. Association between supportive supervision and performance of community health workers in India: a longitudinal multi-level analysis. Hum Resour Health. 2021;19(1):145.
Gupta S, Chatterjee A, Singhal K, Pakhare AP, Joshi A. Understanding the drivers of effective supportive supervision: a realist evaluation of community health worker programs in Madhya Pradesh, India. BMC Health Serv Res. 2025;25(1):1475.
Sabo S, Allen CG, Sutkowi K, Wennerstrom A. Community health workers in the United States: challenges in identifying, surveying, and supporting the workforce. Am J Publ Heal. 2017;107(12):1964-9.
Figueroa CA, Harrison R, Chauhan A, Meyer L. Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Serv Res. 2019;19(1):239.
World Health Organization. The world health report 2006: Working together for health. Available at: https://www.who.int/publications/i/item/9241563176. Accessed 19 February 2026.
Arakeri G, Rao V, Patil S. A crisis of safety: female health-care workers in India need reforms. Lancet. 2024;404(10457):1013-4.
World Health Organization. Global strategy on human resources for health: Workforce, 2030. Available at: https://www.who.int/publications/i/item/9789241511131. Accessed 19 February 2026.
Bonenberger M, Aikins M, Akweongo P, Wyss K. The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study. Hum Resour Health. 2014;12(1):43.
Twineamatsiko A, Mugenyi N, Kuteesa YN, Livingstone ED. Factors associated with retention of health workers in remote public health centers in Northern Uganda: a cross-sectional study. Hum Resour Health. 2023;21(1):83.
Arora N, Hanson K, Spicer N, Estifanos AS, Keraga DW, Welearegay AT, et al. Understanding the importance of non-material factors in retaining community health workers in low-income settings: a qualitative case-study in Ethiopia. BMJ open. 2020;10(10):e037989.
Nega D, Ejeta Chibsa S, Nigusu Y, Melkamu Kitili K, Tolasa G. Job satisfaction and associated factors among rural health extension workers in Buno Bedele Zone South West Ethiopia. Sci Rep. 2024;14(1):20863.
Vlaev I, Schmidtke KA, Balen J, Dormon F. Healthworkers’ motivation in low-and middle-income countries: A systematic review of the literature. Medi Res Arch. 2017;5(8).
Reddy B, Thomas S, Karachiwala B, Sadhu R, Iyer A, Sen G, et al. A scoping review of the impact of organisational factors on providers and related interventions in LMICs: Implications for respectful maternity care. PLOS Glob Publ Heal. 2022;2(10):e0001134.
World Health Organization. Increasing access to health workers in remote and rural areas through improved retention. Available at: https://www.who.int/publications/i/item/9789241564014. Accessed 19 February 2026.
Dugani S, Afari H, Hirschhorn LR, Ratcliffe H, Veillard J, Martin G, et al. Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review. Gates Open Res. 2018;2:4.
Witter S, Hamza MM, Alazemi N, Alluhidan M, Alghaith T, Herbst CH. Human resources for health interventions in high- and middle-income countries: findings of an evidence review. Hum Resour Health. 2020;18(1):43.
Chambers R. The origins and practice of participatory rural appraisal. World Develop. 1994;22(7):953-69.
Clemens MA, Pettersson G. New data on African health professionals abroad. Hum Resour Health. 2008;6(1):1.
Willis-Shattuck M, Bidwell P, Thomas S, Wyness L, Blaauw D, Ditlopo P. Motivation and retention of health workers in developing countries: a systematic review. BMC Health Serv Res. 2008;8(1):247.
Downloads
Published
How to Cite
Issue
Section
