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Institute for Global Health

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Daniel Strachan

Daniel's thesis title is "Ugandan community health worker motivation: using the Social Identity Approach to explore an accepted constraint to scaled up health strategies."

His primary supervisor is Dr Zelee Hill.

To get in touch with Daniel, please email him at d.strachan@ucl.ac.uk.

About Daniel

Daniel Strachan is a Senior Research Associate, Teaching Fellow and completing PhD student at the Institute for Global Health. A social scientist by training, in recent years his work has focused on community health workers and their performance motivation - the subject of his PhD. Most recently Daniel's research focus has returned to early child development through a British Academy Grant in Uganda. This is a long standing area of research interest with Daniel having formally been involved in the development of an online parenting resource in Australia, the Raising Children Network (www.raisingchildren.net.au), as well as early child development policy and service development and evaluation primarily in hard to reach Australian communities. Now based in London Daniel has worked in the UK, across East Africa and in Australia with a focus on communities and health systems that support improving health and developmental outcomes. 

Thesis summary

My PhD examines the work motivation of Ugandan community health workers (CHWs) using the Social Identity Approach (SIA); a social psychological theory. I chose the SIA because it focuses on how group dynamics influence behaviours. Using the SIA heeds calls in the literature for improved social and contextual understanding of CHW work motivation and performance in order to guide development of more effective programmes.

In the PhD I first report how two interventions aiming to improve CHW work motivation were developed based on qualitative, formative research data and the SIA. The first intervention utilised low cost mobile phones and the second community participatory groups. The interventions aimed to build a sense of CHW collective identity by emphasising how CHW programme goals were consistent with achievement of CHW aspirations such as feeling connected to the community and health system. The interventions were tested as part of a larger study using a cluster randomised control trial (RCT) design. This required the development of valid CHW work motivation and social identification measurement scales. While the results of the RCT are not presented within this PhD, I do report on the development of the two scales and present descriptive statistics of the quantitative measures. I include analyses of data generated through qualitative, cognitive interviews and quantitative scale development techniques. The results of qualitative, associative interviews conducted with CHWs during intervention implementation are also presented. These interviews aimed to explore and explain the nature of the relationship between CHW work motivation and social identification and the influence of the two interventions measured during the trial.

In my PhD I demonstrate how the SIA can be used to understand the links between social and contextual influences and CHW work motivation and performance. This represents a new approach to the development of effective CHW work motivation programmes.

Community Health Worker in Western Uganda