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Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

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. more

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Action Plan for Implementation of Recommendations from the Evaluation of PAHO's Response to COVID-19

Pan American Health Organisation PAHO (2024) CC

An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions... more

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UNICEF’s HIV Programming in the Context of COVID-19: Building back better for children, adolescents and women

Unicef (2021) CC2

The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and ... more

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WHO guidelines for the use of thermal ablation for cervical pre-cancer lesions

World Health Organization (2019) C_WHO

It is estimated that more than 311 000 women die of cervical cancer each year. Of these deaths, 91% occur in low- and middle-income countries. Demographic changes and a lack of action mean that the number of deaths per year is projected to reach 460 000 by 2040.

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Guidance Note on Youth Integration into the Women Friendly Health Spaces (WFHS)

United Nations Population Fund UNFPA (2023) CC

UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills &... more

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Annual Report of the WHO Country Office in Zimbabwe, 2022

World Health Organisation (WHO) (2023) C_WHO

This report highlights the work of the World Health Organization (WHO) in Zimbabwe towards contributing to the triple billion targets in the context of the Sustainable Development Goals (SDGs

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PAHO’s Health Emergency Appeal 2023

World Health Organisation (WHO) (2023) C_WHO

This document outlines PAHO’s regional priorities for the year 2023 to sustain and scale up health emergency and humanitarian assistance in the Americas, with a focus on five priority countries currently facing a prolonged humanitarian crisis and recovering from recent acute emergencies: Colombia,... more

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Closing the Gap: The Health Disparities of Older LGBTI People in the Americas

World Health Organisation (WHO) (2023) C_WHO

The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons ... more

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Bahrain - National Action Plan on Antimicrobial Resistance

Kingdom of Bahrain - Ministry of Health (2019) C2

In the kingdom of Bahrain, the national antibiotic committee will set the framework for the national response to AMR, especially bacterial resistance to antibiotics. It will be aligned with the World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance, and with standards and... more

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Global gendered impacts of the Ukraine crisis on energy access and food security and nutrition

Economic Empowerment Section of UN Women United Nations UN (2022) C1

The war in Ukraine has had devasting impact on women and girls worldwide, widening gender gaps and increasing rates of food insecurity, malnutrition and energy poverty. This brief reviews the available evidence of that impact, recommending urgent attention to its consequences for women and girls. I... more

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Operational considerations for the provision of the HIV continuum of care

European Centre for Disease Prevention and Control ECDC (2022) C1

This document provides an overview of key considerations for the provision of the HIV continuum of care in the context of displaced people from Ukraine in the EU/EEA. This document has two aims: firstly, to outline what is known of the Ukrainian HIV epidemic, and secondly, to use the HIV continuum o... more

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Technical note: Girls’ Education, Empowerment, and the Elimination of Female Genital Mutilation

UN Children's Fund UNICEF (2021) C_UNICEF

The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising... more

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Central African Republic: Humanitarian Situation Update - HNO Light, Update as of 22 March 2021

Office for the Coordination of Humanitarian Affairs OCHA (2021) CC

The humanitarian situation in the Central African Republic (CAR) has further worsened over the past six months. Election-related violence that broke out in mid-December 2020 has had a devastating effect on civilians. Thousands of people have been forced to flee, human rights violations have surged, ... more

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Tuberculosis in the Americas. Regional Report 2020

Pan American Health Organisation PAHO (2021) C_WHO

This regional report on the situation of tuberculosis (TB) in the Americas contains information from 2019, provided by the countries of the Region through the World Health Organization TB data collection system. These data have been consolidated and analyzed at the regional level. In addition to pre... more

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Online global consultation on contact tracing for COVID-19, 9-11 June 2020

World Health Organization WHO (2021) C_WHO

COVID-19 has heavily emphasized how contact tracing is crucial for managing outbreaks, and as part of the strategy for adjusting, and eventually lifting, lockdowns and other stringent public health and social measures. As the pandemic develops further, it will be a core measure to manage further wav... more

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Establishing community-led monitoring of HIV services — Principles and process

UNAIDS (2021) CC

25 February 2021 This technical guidance is a living document that builds on guidelines and reports of the UNAIDS Joint Programme. The definitions contained herein are working definitions that are subject to change. Updates will also be added further to the work of the multistakeholder Task Team on... more

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Gendered Health Analysis: COVID-19 in the Americas

Pan American Health Organisation PAHO (2021) C_WHO

This document focus on the direct consequences of the virus (morbidity and mortality) in specific populations and on the results of measures aimed at mitigating the spread of the virus, with indirect impacts on socio-economic conditions. In this complex scenario, the gender approach has not received... more

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Global consultation of National Leprosy Programme managers, partners and affected persons on Global Leprosy Strategy 2021–2030

World Health Organization WHO (2020) C_WHO

The World Health Organization organized a Consultation of National Leprosy Programme managers, partners and affected persons to discuss the draft Global Leprosy Strategy, 2021--2030. This virtual event took place from 26 to 30 October 2020. It was attended by more than 450 stakeholders. Contribution... more

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Zimbabwe Humanitarian Response Plan 2020 (Revised July 2020 to update COVID-19 Response)

UN Office for the Coordination of Humanitarian Affairs OCHA (2020) C1

Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa... more

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Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis in pregnancy. Policy brief

World Health Organization WHO (2020) C_WHO

WHO estimates that in 2015, 257 million people were living with chronic hepatitis B virus (HBV) infection worldwide, and that 900 000 died from HBV infection, mostly through the development of cirrhosis and hepatocellular carcinoma. Worldwide, the majority of persons with chronic hepatitis B infecti... more