Assessment of Community Health Volunteers contribution and factors affecting their health care service delivery in selected urban wards of Puducherry – A mixed-methods operational research study

Introduction
Community participation gained its importance from the Alma Ata declaration in 1978. Improving coverage of these services depends on factors like availability, accessibility, and quality of service delivery. Involving Community Health Volunteers to deliver health services would help in decentralizing health care delivery.

Methods
A mixed-method approach (Sequential experimental design) was employed to evaluate the contributions of CHVs. The data collection methods included Key Informant Interviews (KII) and a pre-tested semi-structured self-introspection questionnaire to capture both volunteer's and health system side perspectives of the intervention. The study was conducted from October 2017 to May 2018.

Results
At the end of the intervention, only 33 volunteers (51%) had contributed to health care delivery in their respective anganwadis. We compiled the contributions made by the CHV during the intervention period. We explored the facilitating, hindering factors that influenced the outcome and gathered suggestions for the same. The CHVs felt that they have contributed adequately to the delivery of health care.

Discussion and conclusion
The study explores the contributions of CHVs and their evaluation using a mixed-methods design capturing the perspectives of various stakeholders. Our study results highlight the spectrum of contributions that can be rendered through CHV's if adequately trained, who can be utilized as an effective workforce in resource-poor settings.