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ORIGINAL ARTICLE
Year : 2015  |  Volume : 18  |  Issue : 1  |  Page : 61-67

Assessment of knowledge and factors that may predict willingness to volunteerism: A pilot study of community-directed distributors in Anambra state


1 Department of Community Medicine and PHC, Enugu State University College of Medicine, Parklane, Nigeria
2 Nnamdi Azikiwe University Medical School, Nnewi, Anambra, Nigeria
3 Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria

Date of Submission03-Jul-2014
Date of Web Publication15-Dec-2014

Correspondence Address:
S U Arinze-Onyia
Department of Community Medicine and PHC, Enugu State University College of Medicine, Parklane, Enugu
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1119-3077.146981

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   Abstract 

Background: Malaria as a leading cause of death in many developing countries requires urgent interventions. In order to improve access to healthcare, trained volunteers are used to distribute health commodities. The present study aims at determining knowledge and factors that may predict willingness to volunteerism in a developing country.
Methodology: This was a cross-sectional descriptive study carried out in 2014 among 284 community-directed distributors in three rural communities in Anambra, Southeast Nigeria using pretested semi-structured questionnaires.
Results: The age range of volunteers was 21-79 years. Most (71.8%) are females and are married (83.1). Only 5.6% of the volunteers did not have any formal education. The predominant occupation is trading (52.5). Most volunteers (78.5%) could define the term volunteerism. Less than half (40.1%) knew the resources that could be volunteered. Most (67.3%) felt that volunteerism is most needed in church activities. Many respondents (58.8%) had volunteered for one or more programs previously. The most common challenge faced was interference with other income generating activities (66.5%). Retired males were more likely to volunteer than retired females (P ≤ 0.01). However, females are more likely to volunteer if the main reason of volunteering is to help people (P ≤ 0.01). The more educated ones believe that volunteerism will help them to be selected for other community programs.
Conclusion: Most respondents had volunteered for other programs and the motivating factors included the satisfaction derived from helping others and the hope of being used for other community programs.

Keywords: Community-directed distributors, knowledge, malaria, volunteerism


How to cite this article:
Arinze-Onyia S U, Modebe I, Aguwa E N, Nwobodo E. Assessment of knowledge and factors that may predict willingness to volunteerism: A pilot study of community-directed distributors in Anambra state . Niger J Clin Pract 2015;18:61-7

How to cite this URL:
Arinze-Onyia S U, Modebe I, Aguwa E N, Nwobodo E. Assessment of knowledge and factors that may predict willingness to volunteerism: A pilot study of community-directed distributors in Anambra state . Niger J Clin Pract [serial online] 2015 [cited 2019 Dec 11];18:61-7. Available from: http://www.njcponline.com/text.asp?2015/18/1/61/146981


   Introduction Top


According to the Centers for Disease Control and Prevention, malaria is one of the most severe public health problems worldwide. It is the leading cause of death and disease in many developing countries where young children and pregnant women are the groups most affected. [1] The challenges of meeting global health care needs in communities throughout the developing world are becoming increasingly complex. [2] Ensuring that available health interventions reach the people who most need them is one of the greatest problems presently facing the health care system. Although global initiatives have improved the delivery of selected health interventions, many priority interventions such as those directed against malaria have unacceptably low coverage.

Building community capacity through the use of trained volunteers is fundamental to both prevention and treatment of malaria especially in resource poor settings like sub-Saharan Africa. The community-directed intervention (CDI) strategy is an approach in which communities themselves direct the planning and implementation of intervention delivery. Adopted by the African Program for Onchocerciasis Control in the mid-1990s, the CDI strategy has helped to ensure and sustain the delivery of annual ivermectin treatment to millions of Africans through the use of community-based volunteers. [3] The success of the CDI strategy in onchocerciasis control sparked widespread interest in applying the strategy and using the established community networks for other interventions. The effect of CDI delivery was especially dramatic for malaria interventions: Coverage with insecticide-treated nets (ITNs) and the percentage of febrile children appropriately treated for malaria more than doubled. [3]

Volunteers represent a growing, but often undervalued section of service delivery in many areas in the community, particularly in health care. [4] It has been reported that community-based health programs making use of volunteers can substantially increase effective access to malaria prevention and also increase access to formal health care in general. [5] Volunteerism is the principle of donating time and energy for the benefit of other people in the community as a social responsibility rather than for any financial reward. [6] It is thus a theory or doctrine that regards the will as the fundamental principle of the individual or the universe. Volunteering to help other people in need has enormous benefits for the community, the environment and even for the individual volunteer. It has been reported that volunteers have less stress and enjoy increased longevity. [7]

In an attempt to ensure that all communities, through their full participation, have access to simple but scientifically sound malaria preventive and treatment services, the National Malaria Control Program supported by Jhpiego and World Bank launched the Malaria Booster Program. [8] The program which is presently being piloted in seven States of Nigeria including Anambra state is using the CDI approach. Here, community-based volunteers called Community Oriented Resource Persons or community-directed distributors (CDDs) who are selected by their own communities are trained to provide safe malaria prevention and treatment services to members of their respective communities. Going by the successes recorded by similar programs in the past, [9],[10] the issue that comes to the fore is ability to retain the volunteers in the program. Understanding what motivates volunteers is important for organizations that seek to harness and develop long-term volunteers in order to meet the need for global health care services. The present study sets out to assess the knowledge and factors that may predict willingness to volunteerism among CDDs in Anambra state. Findings will inform policy direction that should enable long-term sustainability of the program.


   Methodology Top


This was a descriptive cross-sectional study conducted in February, 2014 among 284 CDDs in three rural communities (Ozubulu, Ihiala and Osumenyi) in Anambra central senatorial zone in Southeastern Nigeria with a population of about 158,885 people. Anambra state is mainly inhabited by Igbo speaking people who are mostly Christians. Most members of the population are farmers, artisans and civil servants. The CDDs were selected by their various communities on volunteer basis. Ethical permit for the study was obtained from Ethics Committee of the University of Nigeria Teaching Hospital Enugu while informed consent was obtained from the respondents. The study instrument was a semi-structured self-administered questionnaire which was pretested among CDDs working in another program in the neighboring state. The questionnaire covers the demographic characteristics, knowledge, opinions and experiences on types of services/activities where volunteerism is required and attitudes and reasons for volunteerism.

All the 300 CDDs who were undergoing a training program on community management of malaria as a pilot study organized by the federal government of Nigeria were recruited for the study. However, only 284 who gave informed consent participated. Data were entered and analyzed using SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc. Frequencies and percentages were presented as tables. Pearson Chi-square was used to compare discrete variables while likelihood-ratio Chi-square was used where the expected values in one or more cells is <5. The odds ratio (OR) for each variable was obtained by a computer-generated process where the responses for each question was "Yes" or "No." Hence the reference group for each OR were those whose response to each statement was "No." Level of significance was P < 0.05 and the confidence interval was 95%.

Limitations

The study was subject to some limitations including:

1. The study subjects are already volunteers and as such their responses may be different from those of the general population

2. The subjects were undergoing training which could have affected their responses.


   Results Top


The age range of volunteers was 21-79 years with a modal age range of 31-40 years. Most (71.8%) are females and are married (83.1). Only 5.6% of the volunteers did not have any formal education. The predominant occupation is trading (52.5%) [Table 1]. Most of the volunteers (78.5%) could define the term volunteerism. About 48.6% of the volunteers said that any person could be a volunteer while others felt that only employed or unemployed persons could serve as volunteers. Less than half (40.1%) of the respondents knew that anything (time, money and/or services) could be volunteered. Some others felt it was only money or services or time that could be volunteered. Most of the volunteers (67.3%) felt that volunteerism is most needed in church activities, while only very few (1.8%) felt that sponsoring education of a child could be volunteered work [Table 2].

Many of the respondents (58.8%) had volunteered for one or more programs previously: Females 127 (62.3%) and 40 (50%) males had done volunteer work previously. The commonest volunteer works were immunization (28.9%) and ivermectin distribution (23.2%) while common challenges faced were interference with other income generating activities (66.5%), disruption of routine family life (49.1%) and lack of adequate incentives for the volunteers (38.3%). Retired males were more likely to volunteer than retired females (P < 0.01). However, females are more likely to volunteer if the main reason of volunteering is to help people (P ≤ 0.01). There were no other significant gender differences in the attitude of the volunteers and the reasons for volunteering [Table 3].

Among married persons 134 (56.8%); single persons 8 (61.5%) and widows 25 (71.4%) had been involved in previous volunteer work. Marital status did not affect attitude of the volunteers and reasons for volunteering [Table 4]. Forty-two (out of 80) people with no formal or primary education and 125 (out of 204) people with secondary or postsecondary education had volunteered previously. Retired people with secondary or post-secondary education are more likely to volunteer for programs when they retire than the less educated ones [Table 5]. Similarly, the more educated ones believe that volunteerism will help them to be selected for other community programs. However, significantly more proportions of the less educated volunteers aim at helping people. Incidentally it is more likely that the less educated will discourage the volunteerism because of the feeling that it disturbs their normal family life [Table 5].

The unemployed are most likely to volunteer with the hope that volunteerism will link them up with gainful employment ( P ≤ 0.01) while the employed are more likely to volunteer just for the joy of helping people (P = 0.01) [Table 6].
Table 1: Demographic variables of volunteers


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Table 2: Knowledge, opinion and experiences of volunteers on types of services/activities where volunteerism is required


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Table 3: Attitude and reasons for volunteerism by various sexes


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Table 4: Attitude and reasons for volunteerism by various marital groups


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Table 5: Attitude and reasons for volunteerism by various educational groups


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Table 6: Attitude and reasons for volunteerism by various employment statuses


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   Discussion Top


Volunteerism is a way of giving back to the society. People, irrespective of their age or educational status, generally like to support the community resources that they use or that benefit people they care about. The age of the volunteers in the present study ranged from 21 to over 70 years. This shows that volunteerism knows no age barriers and people of all ages except, of course, for the very young can volunteer one service or the other. A similar age range of 12-76 years had been documented among volunteers in an earlier study. [11] Unlike the previous study where 61% of the volunteers were men, [11] our study like others [12],[13] revealed that the majority of volunteers were females. This could be because women are seen in these communities as humane, kind, readily available and accessible to all members of the community. In addition, men being the breadwinners for most families are usually busy with income-generating activities and may not have time for volunteer services.

Knowledge of respondents on organizations or groups where volunteerism may be required was high particularly regarding church activities and community health services. In contrast, scholarships for children's education and provision of public health education were scarcely mentioned as ways of volunteering. This by implication indicates activities that are commonly provided by volunteers in these communities and those requiring urgent volunteer services. Volunteerism is often needed in various aspects of human endeavor including education, health, community development, environmental management, services for the children, youths, elderly, the disabled, disaster victims as well as for animals and pets. [14] As has been previously reported, volunteerism is a long-term behavior, most people who volunteer continue to do so for an extended period. [15] In the present study, 58.8% of the respondents had worked previously as a volunteer in different programs, including immunization, ivermectin, Vitamin A and/or insecticide treated nets (ITNs) distribution. This could be, as a result, of the confidence the community has on them having tried and tested them in other programs and found them to be trustworthy. It could also be from their interest and willingness to help other people.

Expectedly, the major challenges encountered by our volunteers were interference with other income generating activities and disruption of routine family life. These are comparable to other reports where work commitments, lack of free time, family obligations and burnout were the major barriers to volunteerism. [16],[17] This indicates the need for modification of volunteer programs in order to avoid unnecessary interference with family obligations and other work commitments particularly economic activities. In contrast to the previous finding that within the retirement population, men are less likely to volunteer than women, [18] our study revealed that retired men are more likely to volunteer than retired women. This could be, as a result, of higher confidence among the retired men in their ability to provide services. The retired women, on the other hand, might be occupied by domestic work at home and as a result, may neither have the time nor energy for volunteer services.

Understanding the reasons for volunteering is critical to volunteers' retention. Some people would offer voluntary services without expecting any form of payment mainly in religious activities or to help people in need. However, in the present study, though 58.8% of respondents have existing experience with volunteering, only 38% had a positive attitude towards volunteerism. This may be because some volunteer with the hope of getting incentives like gainful employment and financial benefit. These serve as motivators to volunteer without which they may have a negative attitude toward further volunteer works. Many motivators have been recorded in the past such as a feeling of being appreciated, [16] nonmaterial incentives like community recognition, feeling of making a contribution and pride in the services provided. [3] Other motivating factors include psychological and emotional rewards, career-related benefits, opportunities for interpersonal interaction and the opportunity to serve disadvantaged communities. [2]

Similar to previous findings, [19] retired people with secondary or higher education are significantly more likely to volunteer than the less educated ones. This is probably as a result of the confidence they have in their ability to deliver services particularly among the professionals. For the other respondents, the more educated respondents are more likely to volunteer in order to be selected for other community programs, while the less educated are likely to volunteer for the joy of helping other people in need. The views of literature on the impact of educational status on volunteerism differ. While some reported an inverse relationship between the amount of education and the likelihood to volunteer especially in religious programs, [11] others noted a clear positive correlation between educational levels and the tendency to volunteer. [20]


   Conclusion and Recommendations Top


Most of the volunteers were familiar with the term volunteerism but only a few had in-depth knowledge of the term. More than half had volunteered for other programs and the motivating factors included the satisfaction derived from helping others and the hope of being used for other community programs. Major challenges identified were interference with income-generating activities and disruption of routine family life. Hence, it is recommended that project managers should modify programs in such a manner as to enable volunteers attend to their personal needs as well.

 
   References Top

1.
CDC-Malaria-Malaria worldwide-Impact of malaria, 2014 Mar. Available from: http://www.cdc.gov/malaria/malaria_worldwide/impact.html. [Last accessed on 2014 Apr 20].  Back to cited text no. 1
    
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3.
CDI Study Group. Community-directed interventions for priority health problems in Africa: Results of a multicountry study. Bull World Health Organ 2010;88:509-18.  Back to cited text no. 3
    
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Downie J, Clark K, Clemenston K. Volunteerism: 'Community mothers' in action. Contemp Nurse 2004;18:188-98.  Back to cited text no. 4
    
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Okeibunor JC, Orji BC, Brieger W, Ishola G, Otolorin E', Rawlins B, et al. Preventing malaria in pregnancy through community-directed interventions: Evidence from Akwa Ibom State, Nigeria. Malar J 2011;10:227.  Back to cited text no. 5
    
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7.
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8.
Jhpiego. A training program in community-directed intervention (CDI) to improve access to essential health services. Available from: http://www.jhpiego.org/content/training-program-community-directed -intervention-cdi-improve-access-essential-health-service. [Last accessed on 2014 Apr 20].  Back to cited text no. 8
    
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Ndiaye Y, Ndiaye JL, Cisse B, Blanas D, Bassene J, Manga IA, et al. Community case management in malaria: Review and perspectives after four years of operational experience in Saraya district, South-east Senegal. Malar J 2013;12:240.  Back to cited text no. 10
    
11.
Ruebush TK 2 nd , Godoy HA. Community participation in malaria surveillance and treatment. I. The Volunteer Collaborator Network of Guatemala. Am J Trop Med Hyg 1992;46:248-60.  Back to cited text no. 11
    
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Manning LK. Gender and religious differences associated with volunteering in later life. J Women Aging. 2010; 22 (2): 125-35.  Back to cited text no. 12
    
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Claxton-Oldfield S, Claxton-Oldfield J. Should I stay or should I go: A study of hospice palliative care volunteer satisfaction and retention. Am J Hosp Palliat Care 2012;29:525-30.  Back to cited text no. 16
    
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Mjelde-Mossey LA, Chi I, Chow N. Volunteering in the social services: Preferences, expectations, barriers and motivation of aging Chinese professionals in Hong Kong. Hallym Int J Aging 2002;4:31-44.  Back to cited text no. 17
    
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Havens J, McNamara TK. Civic engagement: Volunteering dynamics and flexible work option. The Center on Aging and Work, 2007 May. Available from: http://www.bc.edu/content/dam/files/research_sites/agingandwork/pdf/publications/IB07_volunteeringDynamics.pdf. [Last accessed on 2014 Apr 20].  Back to cited text no. 18
    
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Erlinghagen M, Hank K. The participation of older Europeans in volunteer work. Ageing and Society. 2006;26:567-84.  Back to cited text no. 19
    
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Mathou C. Volunteering in the European Union. Available from: http://www.ec.europa.eu/citizenship/pdf/doc1018_en.pdf. [Last accessed on 2010 Feb 24].  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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