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In addition, a study in North Viet Nam identified appreciation and recognition as the most highly ranked motivators [ 50].
Dieleman et al. examined health workers' job perception and motivation in Vietnam and identified "appreciation and support by managers and colleagues" as a factor for motivation [ 18].
Similarly, an exploratory qualitative study of 24 health workers in Viet Nam identified appreciation by managers, colleagues and the community as one of the main motivating factors [ 31].
A qualitative study of what motivated rural health workers in Vietnam identified appreciation, job stability, regular income and continuing education as the main motivating factors, and low income and allowances as the main discouraging factors [ 13].
In a qualitative study at the UFSC Faculty of Medicine, Zonta et al. (2006) identified appreciation of interpersonal relationships and everyday life phenomena, balance between study and leisure, time management, health care, food and sleep, physical activity, religiosity, working on one's own personality to deal with adverse situations and seeking psychological assistance [ 16].
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A study among rural health workers in North Vietnam, for example, revealed that the most motivating factors in their job were identified as appreciation by managers, and colleagues, appreciation by the community, a stable job and income and training [ 38].
A limited number of studies explicitly researched possible objections to the opt-out system and not only found this method to be generally accepted but additionally identified patients' appreciation of participation in research [ 7, 8].
Participants identified under-appreciation of effective communication within the hospital and addressing the wrong target group as important causes for communication problems during crises.
Our analytical strategy to identify respondents' appreciation of group-based principles for action was thematic and data driven [ 66].
The research identified substantial shared appreciation of woodland landscapes across 'professional' and 'lay' social groups, challenging several previous studies.
This study highlights the perceived benefits of the CHW system such as strong motivation and appreciation, as identified by CHWs themselves as well as their beneficiaries, in addition to the barriers that impede the effectiveness of the programme, including challenges of the cPBF system and irregular trainings.
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