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1
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 accompan
...
iment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain 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.
more
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 mortality
more
In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health
...
centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising regional and national referral hospitals [Figure 3].
more
While motivational factors vary, opportunities for career advancement, stimulating and challenging tasks, opportunities for promotion, and co-worker recognition are core factors that can engender retention of rural health workers. Interventions are
...
required to enhance rural health worker motivation and retention, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. Strategies around retention need to be addressed as these would better enable rural primary health workers to cope with the challenging conditions they work in rural areas.
more
Lessons learned from recent public health events such as the COVID-19 pandemic, Ebola virus disease, Zika virus disease outbreaks, and other public health threats, including earthquakes and floods,
...
have highlighted the need for countries to continuously develop, strengthen, and maintain capacities required under the International Health Regulations (2005) (IHR (2005)).
Developing capacities for health security in a country requires the engagement of public and private entities across a broad range of sectors, including human and animal health, agriculture, environment, finance, security, emergency management, education, and transportation. The World Health Organization (WHO) is mandated through various resolutions, decisions, and reports of the World Health Assembly, and through the IHR (2005), to provide technical guidance and support to its Member States in developing, strengthening, and maintaining their health systems, including capacities required under the IHR (2005).
For countries to better prevent, prepare for, detect, notify, respond to, and recover from public health emergencies, they must build and maintain IHR core capacities and support the strengthening of health emergency prevention, preparedness, response, and resilience (HEPR) capacities. National Action Plans for Health Security (NAPHS), as capacity development plans, provide the tasks and resources needed to ensure adequate capacities are in place to prevent, detect, respond to, and recover from public health events in a sustainable manner. Investing in the resilience of these capacities within national health systems at national and local levels not only improves national health security but also helps safeguard economic, social, and political developments.
more
WHO, as the coordinating authority on international health, supports countries in protecting public health through evidence-based policies and actions. Considering the significant
...
health burden and the multiple potential benefits of interventions, the WHO Air Quality, Energy and Health Unit aims to support countries by providing evidence, building institutional capacity and leveraging the “health argument” to convene sectors to tackle air pollution and accelerate energy access.
more
The document is a practical handbook developed by the European Centre for Disease Prevention and Control (ECDC) that provides guidance on how to design, plan, conduct, and evaluate simulation exercises in public health settings. Its main purpose is
...
to help organisations improve their preparedness and response to communicable disease outbreaks by using structured exercises as a training and evaluation tool. The handbook explains different types of exercises, outlines the steps involved in organising them, and highlights the importance of clear objectives, coordination, and evaluation. Overall, it aims to strengthen emergency preparedness by enabling organisations to identify weaknesses, improve collaboration, and enhance their ability to respond effectively to public health crises.
more
In this guideline, natural ventilation is considered
among one the effective measures to control infections in health care. This guideline provides
a design and operation guide for hospital planners, engineers, architects and infection control
...
personnel. The recommendations in this guideline followed a systematic
review of the literature on the association of ventilation and disease transmission, as well
as effective natural ventilation solutions for infection control.
more
This document provides information for WHO Member States, particularly low-income and middle-income countries, to strengthen preparedness and response plans with regard to the social and mental health consequences of biological and chemical attacks.
...
more
A guide to Primary Health Care Facility Supervision
Standards for improving quality of maternal and newborn care in health facilities
recommended
Bernadette Daelmans, Olufemi Oladapo, Özge Tuncalp et al
World Health Organization (WHO)
(2016)
C_WHO
The standards of care cover the routine care and management of complications occurring for women and their babies during labour, childbirth and the early postnatal period, including those of small babies during the first week of life. They define priorities for improving the quality of maternal and
...
newborn care for use by planners, managers and health care providers
more
Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrob
...
ial stewardship” (AMS). Stewardship has since been applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
more
The Report describes the evaluation of WHO's contribution to the Maternal Health Program in South-East Asia Region. This was an independent evaluation conducted in 2015 by Amaltas, a Delhi based organization. The evaluation highlights the progress i
...
n five countries, namely Bangladesh, Indonesia, Myanmar, Nepal and Sri Lanka and provides specific recommendations for Organizational Learning and Development. This report will be useful for all those interested in WHO's work on Maternal Health Program in the Region.
more
This external performance evaluation of the Malawi Girls’ Empowerment through Education and Health Activity (ASPIRE), conducted 2.5 years after ASPIRE began, establishes the activity’s progress against its objectives, proposes adaptations for th
...
e final year, and captures lessons for application in future girls’ empowerment, health, and education programming in Malawi.
more
Positionen, Lernziele und methodische Empfehlungen.
Mit diesem Dokument soll die Diskussion um mögliche Konzepte zur Erweiterung der medizinischen Ausbildung um das disziplinübergreifende Fachgebiet Global Health anzuregen, bestehende fachliche R
...
essourcen unter diesem Dach zu vereinen und von studentischer Seite Beiträge für eine Aufwertung von Public Health, International Health sowie globalen sozialen Fragen in der medizinischen Ausbildung zu leisten.
more