Background   Since the Alma Ata Declaration in 1978, Community Health Volunteers (CHVs) have become critical assets to assist tuberculosis (TB) control programs in low and middle-income countries, such as in case finding and treatment support activities. Yet community-based tuberculosis control programs (CBTBC) are faced with numerous challenges, including recruitment and retaining of CHVs. While the possible effect of financial incentives has been extensively discussed, other motivational factors have received less attention. Objective   This study sought to explore on potential motivations for entering, remaining, and exiting volunteer work among CHVs working in a CBTBC project run by an NGO, Japan Anti-Tuberculosis Association (JATA), in urban townships of Yangon, Myanmar.Methods   A semi-structured questionnaire was administered to CHVs who were working for a JATA CBTBC project in Yangon, Myanmar. The questionnaire consisted of closed- and open-ended questions asking about demographic characteristics, their experiences, and their motivations for entering, remaining and exiting volunteer work. Functional theory of motivation was used as a conceptual framework for analysis.Results   A total of 69 volunteers participated in the survey, representing 69% of all CHVs for JATA CBTBC (69/100). From the questionnaire, we found that altruism, self-empowerment, and psychological job satisfaction mainly influenced CHVs’ motivation to enter and remain in volunteer work. Expectations for financial incentives were less important. Being busy with housework and other work priorities could motivate them to temporarily exist volunteer work, while ill-health and old age potentially triggered permanent exit. Conclusions   CHVs working in JATA CBTBC were motivated mainly by altruism, self-empowerment, and psychological job satisfaction - however, their volunteer work must be systematically supported so as to avoid unnecessary burden on CHVs. Further qualitative study would extend the evidences of the potential factors which might contribute to sustaining CHV participation.

BACKGROUND: Like most women, female nurses in the workforce experience life events such as marriage, childbirth, and child-rearing, and carry out numerous personal roles. This may result in an increase in various demands for nurses, and coping with these roles may promote work engagement. However, few studies have focused on work engagement or spillover effects, including those in the family domain, in female nurses with multiple roles. In the present study, we aimed to examine work engagement in female nurses and investigate its relationship with factors such as the presence or absence of multiple personal roles. METHODS: The subjects of this study were 1225 female nurses working at three general hospitals, each with at least 200 hospital beds in Fukuoka Prefecture, Japan. The cross-sectional design of the study used anonymous self-administered questionnaires. Responses were received from 650 nurses (response rate 53.1%), of which 612 were valid (valid response rate 50.0%). Multiple regression analysis was performed on the 612 responses regarding associations between work engagement and the presence or absence of multiple roles (role as a wife or mother), spillover effects, coping characteristics, job demands, and job resources. RESULTS: In general, the work engagement of female nurses was low, as is the case with other female workers in Japan, but work engagement was higher among female nurses with multiple roles than among those without. The regression analysis showed that factors associated with better work engagement in female nurses were family-to-work positive spillover, job resources, coping strategies including "changing a point of view," "active solution for problems," "avoidance and suppression," and the presence of multiple roles. CONCLUSIONS The results indicate that in addition to resources in the work domain, a family-to-work positive spillover effect, which is a variable in the non-work domain, may also promote energetic work among female nurses. Therefore, it is necessary for nurses to receive support at work and use effective coping strategies.