These observations were written down daily, and later provided contextual information for the carrying-out of the thematic analysis. Data analysis The aim BAY 73-4506 in applied ethnographic research is to study a particular situation or context in order to find the constructs, structures and phenomena that constitute a dynamic social process in a way that allows comparison with social groups that might be similar or very different [22,23]. Comparability and translatability are analog to the positivist construct of generalizability and validity, and they allow an ethnographer to gather data that provides a depth of understanding that would be impossible to gain through any other method [22]. By using thematic analysis, we identified themes characterizing the experiences of being a CHW in Palencia [24].

Thematic analysis allows researchers to group codes and categories that are similar into themes that reflect specific patterns in the data [22]. This happened through the process of careful reading and coding of the data into meaning units grounded in the text [25]. In our analysis, we identified emerging and a priori codes that were part of our interview guide. We summarized transcripts and outlined key points in the interviews, coded using the open code software program and identified categories through an interactive process between the researchers. The categories were then linked into themes and later corroborated by close scrutiny of the analysis [24,26]. The extensive field notes also provided rich information for the context of the interviews and served as additional documentation of the informal conversations between the first author and the facilitadores/health team.

Ethical considerations In Guatemala, it is only necessary to ask for ethical clearance when conducting clinical trials or human testing. However, we procured ethical clearance with the local municipal authorities, with the MoH and with the community health workers in our study. We did this by presenting our project and our methodology to all the participants. We obtained verbal informed consent from the interviewees and informed them that they could withdraw at any time without any consequences. We asked permission to tape record the interviews or to take notes, and guaranteed anonymity to all participants. In the findings, we used pseudonyms to protect our informant��s identities.

We later shared the results with all the informants. Results We have characterized the experience of being a community health worker in Palencia into three themes: getting started, the motivation required for the job and finally, the work of a CHW. Theme 1: Getting started There were four different ways of getting involved as a facilitador comunitario in Batimastat Palencia. The most common case in this municipality was to be asked by the community to ��step-up�� to the position.