Motivation and sustainability of care facilitators engaged in a community home-based HIV/AIDS program in Masvingo Province, Zimbabwe.

Community home-based HIV/AIDS programs with care facilitators (CFs) are key interventions for dealing with both the shortage of health professionals (e.g., physicians, nurses, midwives, etc.) and the current HIV/AIDS epidemic in many parts of Africa. Zimbabwe, one of the sub-Saharan countries is not an exception. The Zimbabwe Red Cross Society started a community home-based HIV/AIDS program with CFs in 1992. This paper describes the results of a cross-sectional study conducted to examine the factors influencing the motivational outcome and self-assessed performance of CFs from one province involved in this program. Self-administered questionnaires provided to CFs were analyzed by chi-square test and multiple liner regression. The response rate was 71.7% (15 male, 104 female). Results showed that 46.8% of CFs in rural area had worked more than five years whilst only 18.5% of CFs in urban area did (p<0.05). The motivational outcome and self-assessed performance of CFs were significantly associated with perception toward family and community environment (beta=0.462, SE=0.092, p<0.001 and beta=0.496, SE=0.173, p<0.001, respectively) and perception toward organizational characteristics, specially managerial support, like attention from a manager, clear instruction, and goals, had an impact to CFs motivational outcome. These findings suggest that organization need to create the policy consistent with community need and provide clear goal and instruction to improve to motivation and performance of CFs.