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Rewarding altruism: Addressing the issue of payments for volunteers in public health initiatives

Author

Listed:
  • South, Jane
  • Purcell, Martin E.
  • Branney, Peter
  • Gamsu, Mark
  • White, Judy

Abstract

Lay involvement in public health programmes occurs through formalised lay health worker (LHW) and other volunteer roles. Whether such participation should be supported, or indeed rewarded, by payment is a critical question. With reference to policy in England, UK, this paper argues how framing citizen involvement in health only as time freely given does not account for the complexities of practice, nor intrinsic motivations. The paper reports results on payment drawn from a study of approaches to support lay people in public health roles, conducted in England, 2007–9. The first phase of the study comprised a scoping review of 224 publications, three public hearings and a register of projects. Findings revealed the diversity of approaches to payment, but also the contested nature of the topic. The second phase investigated programme support matters in five case studies of public health projects, which were selected primarily to reflect role types. All five projects involved volunteers, with two utilising forms of payment to support engagement. Interviews were conducted with a sample of project staff, LHWs (paid and unpaid), external partners and service users. Drawing on both lay and professional perspectives, the paper explores how payment relates to social context as well as various motivations for giving, receiving or declining financial support. The findings show that personal costs are not always absorbed, and that there is a potential conflict between financial support, whether sessional payment or expenses, and welfare benefits. In identifying some of the advantages and disadvantages of payment, the paper highlights the complexity of an issue often addressed only superficially. It concludes that, in order to support citizen involvement, fairness and value should be considered alongside pragmatic matters of programme management; however policy conflicts need to be resolved to ensure that employment and welfare rights are maintained.

Suggested Citation

  • South, Jane & Purcell, Martin E. & Branney, Peter & Gamsu, Mark & White, Judy, 2014. "Rewarding altruism: Addressing the issue of payments for volunteers in public health initiatives," Social Science & Medicine, Elsevier, vol. 104(C), pages 80-87.
  • Handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:80-87
    DOI: 10.1016/j.socscimed.2013.11.058
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    References listed on IDEAS

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    1. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    2. Carpenter, Jeffrey & Myers, Caitlin Knowles, 2010. "Why volunteer? Evidence on the role of altruism, image, and incentives," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 911-920, December.
    3. Glenton, Claire & Scheel, Inger B. & Pradhan, Sabina & Lewin, Simon & Hodgins, Stephen & Shrestha, Vijaya, 2010. "The female community health volunteer programme in Nepal: Decision makers' perceptions of volunteerism, payment and other incentives," Social Science & Medicine, Elsevier, vol. 70(12), pages 1920-1927, June.
    4. Marks, Michael B., 2012. "Time banking service exchange systems: A review of the research and policy and practice implications in support of youth in transition," Children and Youth Services Review, Elsevier, vol. 34(7), pages 1230-1236.
    5. Witmer, A. & Seifer, S.D. & Finocchio, L. & Leslie, J. & O'Neil, E.H., 1995. "Community health workers: integral members of the health care work force," American Journal of Public Health, American Public Health Association, vol. 85(8), pages 1055-1058.
    6. Ziemek, Susanne, 2006. "Economic analysis of volunteers' motivations--A cross-country study," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 35(3), pages 532-555, June.
    7. Andreoni, James, 1990. "Impure Altruism and Donations to Public Goods: A Theory of Warm-Glow Giving?," Economic Journal, Royal Economic Society, vol. 100(401), pages 464-477, June.
    8. Bruno S. Frey & Lorenz Goette, "undated". "Does Pay Motivate Volunteers?," IEW - Working Papers 007, Institute for Empirical Research in Economics - University of Zurich.
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    Cited by:

    1. Wallace, Carolyn & Farmer, Jane & McCosker, Anthony, 2019. "Boundary spanning practices of community connectors for engaging ‘hardly reached’ people in health services," Social Science & Medicine, Elsevier, vol. 232(C), pages 366-373.

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