Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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This article provides an overview of the current and projected climate change risks and impacts to mental health and provides recommendations for priority actions to address the mental health consequences of climate change.
General practitioners and pediatricians must know the signs and
symptoms of possible pediatric cancer.
Rund drei Viertel der in Deutschland lebenden Flüchtlinge aus Syrien, dem Irak und Afghanistan sind nach Gewalterlebnissen traumatisiert.
Le présent document expose des recommandations exhaustives de l’OMS sur les soins prénatals systématiques à l’intention des femmes enceintes et des adolescentes. Le but de ces recommandations est de compléter les directives de l’OMS existantes sur la prise en charge des complications spé...cifiques associées à la grossesse. Elles sont destinées à refléter et à répondre à la nature complexe des problèmes entourant la pratique et la délivrance des soins prénatals et à donner la priorité à la santé et au bien-être de la personne – et pas seulement à la prévention de la mortalité et de la morbidité – selon une démarche visant le respect des droits de l’homme.
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Ade et al. BMC Health Services Research (2016) 16:5
Background: In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about
the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the
possible b...enefits on improving treatment outcomes. This study aimed to determine the contribution of tracing
activities for those who missed scheduled appointments towards a successful treatment outcome.
Methods: A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients
treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment
outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their
scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed
to explore factors associated with missing a scheduled appointment
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Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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PLoS ONE 18(5): e0285031. https://doi.org/10.1371/journal.pone.0285031
The study aims to integrate HPV vaccination into routine care in adolescent HIV clinics. To achieve success, we will co-design a package of implementation strategies using a previously successful implementation research approach... developed for cervical cancer prevention in LMICs: the Integrative Systems Praxis for Implementation Research (INSPIRE). INSPIRE is a novel, comprehensive approach to develop, implement, and evaluate implementation science efforts
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La Stratégie nationale de communication pour le paludisme 2017–2020 de la République Démocratique du Congo vise à améliorer les comportements de prévention, de détection et de traitement du paludisme à travers une communication sociale et comportementale (CSC) structurée et contextuelle. ...Élaborée par le Programme National de Lutte contre le Paludisme (PNLP), elle s’inscrit dans la vision d’un accès équitable aux messages de santé et à des services de qualité pour toute la population.
Cette stratégie met l’accent sur l’adoption de pratiques essentielles telles que l’utilisation correcte des moustiquaires imprégnées, le recours systématique au test de diagnostic rapide avant tout traitement, la prise en charge précoce des cas, en particulier chez les enfants de moins de cinq ans et les femmes enceintes, ainsi que l’adhésion complète aux traitements prescrits. Elle cible prioritairement les ménages, les femmes enceintes, les enfants, les agents de santé communautaires, les enseignants, les leaders religieux et les médias.
Pour atteindre ses objectifs, la stratégie mobilise plusieurs canaux de communication, notamment les médias de masse (radio, télévision, affichage), la communication interpersonnelle via les agents communautaires, et des campagnes de mobilisation sociale. Elle identifie également plusieurs obstacles, tels que les croyances erronées, le faible niveau d’éducation sanitaire et les disparités d’accès à l’information dans les zones rurales.
Enfin, le document propose des mécanismes de suivi et d’évaluation clairs, avec des indicateurs pour mesurer l’exposition aux messages, la compréhension, et les changements de comportement au sein des communautés. Cette stratégie vise à créer un environnement favorable à la réduction durable du fardeau du paludisme en RDC.
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Manuel de référence pour les accoucheurs qualifiés