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Mixed Methods Sequential Epidemiological Protocol (MMSEP) for Evaluation of Time Utilization by the Community Health Workers and Factors Affecting its Optimization

Background - Many countries have a significant shortage of healthcare staff, resulting in a reduction in the range and quality of services. Low and middle-income countries rely heavily on Community Health Workers. Existing data suggests a lack of clarity regarding the scope of work as well as about the utilization of the working hours. The purpose of this work is to propose a protocol to evaluate the time utilization of the Community Health Workers and to identify the promoters and challenges that they come across while delivering their duties so that the workflow optimization processes can be hypothesized. Methods -The Mixed Methods Sequential Epidemiological Protocol incorporates three phases. Phase I includes free listing to identify Community Health Workers' workflow using a generic form with a single open-ended question for each cadre. After pile-sorting the free lists, the pile names should be used as categories for the time-motion study to be done in phase II. For each of these categories, time spent should be recorded and analyzed. Phase III includes in-depth interviews with Community Health Workers who use considerably varied times for the same category of work. Discussion- The intended study will help in comparing the workflow of different cadres of health workers and finding out different factors promoting and inhibiting better utilization of their working hours. This approach will inform reasonable and feasible improvements to health-related planning of services and utilization of the health workforce and will help in increasing the efficiency of health workers to deliver services.