Motivation, job satisfaction, and self-efficacy of community health workers in Bolivia: evidence from a large NGO-run program

Community health workers (CHWs) are an important health workforce in Latin American countries, connecting residents with limited resources with the formal health care system. CHWs’ motivation, job satisfaction, and self-efficacy affect their job performance, their desire to continue in their work, and the stability of the workforce, which can in turn impact the health care systems they support and the communities they serve. This study aims to explore the motivation, job satisfaction, and self-efficacy of volunteer CHWs in Bolivia—a setting where few studies have been conducted—and the factors influencing these outcomes. This study used a mixed-methods design that included qualitative and quantitative data collection and analysis. Qualitative interviews were conducted with a purposive sample at five locations across Bolivia where Pro Mujer, a local NGO, implements a CHW program. A quantitative survey was distributed to participants from all Pro Mujer CHW project sites. Both the survey and interview guide consisted of questions exploring CHW experiences, health effects, motivation, job satisfaction, self-efficacy, professional development, and perceived challenges. This study found that CHWs’ motivation, job satisfaction, and self-efficacy are closely connected to their capacity to help others, learn new skills and knowledge, receive incentives, build supportive relationships, and have opportunities for career advancement. They report increased self-confidence, self-esteem, and a feeling of pride because of their role as a CHW. Overall, CHWs in Bolivia have high levels of job satisfaction and self-efficacy, despite facing many challenges related to financial limitations, lack of time, and balancing responsibilities at home, school, and paid work. When CHWs are equipped with up-to-date, ongoing training, supportive supervision, and adequate incentives—particularly in the context of Bolivia’s ongoing economic challenges—they feel they will be more likely to remain in their roles. Few studies have focused on volunteer CHWs in Bolivia, and this is the first to analyze the factors that contribute to their motivation, job satisfaction, and self-efficacy. Interventions to help CHWs advance professionally through specialized training, scholarships, and mentoring programs may serve as a powerful source of sustained motivation and job satisfaction.