Rural Interdisciplinary Sociology of Village Health Committee Stipend Payment Delays and Community Health Worker Attrition in Malawian Health Centre Catchments: A Discrete-Time Hazard Estimation of Payment Arrears

Village health committees in Malawi's health centre catchments are central to community health service delivery, yet their members receive stipends that are frequently paid late. The framework specifies the hazard of exit at each month of committee tenure as a function of cumulative arrears, distinguishing between the extensive margin (whether any payment has been received) and the intensive margin (how long payment has been outstanding). It further incorporates catchment-level institutional covariates, including health centre supervision frequency and committee record-keeping quality, that condition the effect of arrears on exit. The framework is presented as a methodological and conceptual contribution rather than an empirical estimate: no observational data are analysed, and the parameters of the hazard specification are derived from the logic of the payment relationship rather than from field measurement. Stipend arrears operate through a mechanism of reciprocal obligation breach, in which committee members interpret delayed payment as evidence that their voluntary labour is not valued, and that this interpretation is conditioned by the visibility of payment delays within the committee and the availability of alternative income activities. The framework yields testable propositions about the shape of the hazard function, the threshold at which arrears become salient, and the interaction between arrears and supervision intensity. It contributes a specification that can be applied to routine committee records in Malawian health centre catchments, and it clarifies why cross-sectional analyses of stipend levels have produced inconsistent findings about volunteer retention.