Table 2 Illustrative excerpts from interviews on external sources of motivation

Monetary rewards

•The reason of this job is to support my family. Due to some reason, my husband is not working and stops me to do so, too. He is addict, use foul language, I am the sole earner of family for 20 years (LHW G)

•This is a basic principle that individual work for reward or money, and this is a source of encouragement, you can inspire with two methods, as these days’ people have financial crisis, therefore, monetary incentives attract more. (LHW G)

•In my opinion, whoever paid well, will perform well, Money will act as petrol and she will run fast for her work. If will not get any compensation, she will say there are ten more who are sitting and doing nothing, why should I go? (Programme manager G)

•The monetary incentive given for TB is adequate, even if it’s not given, this is our duty and we need to do it at any cost. (LHW S)

•The reward of rupees 1000 is given per TB case is being utilized for all the transport expenses of the patient till his last check-up. LHW belong to poor families, so if we have money only then we can help our patients. (LHW S)

•The amount of Rs. 1000 should be given to us because we bring patients from far flung areas, when they reach at centre, sometimes no electricity, staff is on leave, then we have to bring them again, so almost Rs. 500 is spend on commuting, therefore, the amount is very less and it should be increased. (LHW U)

•As per my observation, if there are incentives, LHW remains motivated and they achieve their targets well, but if they don’t receive any incentives, they will work just like that without any efforts to achieve her target. They won’t bother to send referrals, so without incentives, there is no desire to work. (Programme manager U)

Non-monetary material rewards

•Health workers should get food package as per their economic conditions, also, free medical care must be provided (LHW G)

•In my opinion, providing other facilities instead of money is better for LHW. Compensating with money is not a bad thing, as it is reward of their hard work, but, offering health and other facilities will be more beneficial. (Programme manager G)

•We are tired of borrowing money from people, therefore, we want that we should be given food packages on our good performance or at least we should be paid regularly, so that we don’t need anything else. (LHW S)

•There are field workers who demands for food packages on their good performance, but it seems inappropriate, though there must be free medical facility (LHW S)

•The financial status of most of the LHW is not that good, so if they are given a food package on their good performance, this will be beneficial and a source of motivation for them. (Programme manager S)

•If we get free medical facility, it would be better (than monetary awards) because sickness makes us worry. (LHW U)

•In return of our work and best performance, if we get free medical facility we will be happy because good health is important. If we are ill, how can we work? If we get proper medicine and access to the doctor for check-up, then it will be a good incentive, whereas food packages are not that important for us because, if we get salary on time, we can buy our own food ration. (LHW U)

•If other companies are providing incentives on the basis of performance then we should also we should also get medical facility. God gives us food; we can arrange our own food but free medical should be given. (LHW U)

Social

•Look, wherever you are working, appreciation is important, one is working hard and if there is no appreciation then consider it as incomplete. (Programme manager G)

•There was an event for girls who performed well, I was so delighted to receive an award. It gives us encouragement to see that we get acknowledged among people, there is someone, who cares about our efforts. (LHW G)

•Few workers were given shields as a token of appreciation, but I was not given one, since I had less TB patients. I hope to get a shield next time. (LHW S)

•In my opinion, getting shield among everyone is a matter of pride. Money comes and spend but the impact of recognition in terms of shield remains for longer period (LHW S)

•In the seminar I was honoured and when in front of everyone bestowed the award, I showed it on my return to the village that I got this award for the work I have done, so it made me happy. (LHW U)

•Elders in the community also gives us respect, and take my advice on health matters, they come to me first. (LHW G)

•People in the area love us and respect us because we do work and visit each home. (LHW G)

•I never thought of leaving this job, I continue it because I get respect from others. (LHW G)

•People give us extra importance and respect us. Whenever, I visit the household they bring stuff to eat, despite refusing for it. They say you are our ‘baji’ who came to help us, then should have some tea or soft drink. (LHW S)

•I am proud of working as LHW. I can be helpful for others; women share their private matters with us, which they can’t do with other people. (LHW S)

•Community people appreciate our efforts and asks, when we will meet them and visit their houses, they give us more respect. They ask about us, when our visit got delayed or take more days. They trust us and listen to our advice attentively, it makes us happy, particularly, when they follow, what we told them to do. (LHW U)

•Community is recognizing LHW work because they realize their performance in the health matters. (Programme manager U)