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Publication Years
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2
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
The Ministry of Health through the National AIDS Secretariat, has developed the Strategic Operational Plan for Condom Programming in Sierra Leone with a focus on reinvigorating condom use to ensure “uninterrupted access to male and female condoms
...
and lubricants for Key Populations, young people and the general population.” Condom use in the country was estimated at 7 per cent and 23 per cent of women and men respectively who had sexual intercourse with non-regular partners. The primary goal of the strategic operational plan is to enhance access and utilization of male and female condoms, supporting national efforts to reduce the transmission of sexually transmitted infections (STIs), including HIV, and unintended pregnancies, for all sexually active individuals.
more
Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before th
...
e pandemic, evidence showed the significant returns on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COVID-19 pandemic - investments in social determinants can mitigate widespread reductions in human capital and the increasing likelihood of costly syndemics, while promoting access to healthcare innovations that have thus far been inequitably distributed. Therefore, we argue that, despite immediate fiscal pressures, this is exactly the time to invest in health equity and its broader social determinants, as the returns on such investments have never been greater.
more
This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (
...
SDGs). The findings reveal wide disparities in governments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middleincome
countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, it will not be sufficient on its own. Effective responses also
require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDGs.
more
This issue brief provides information about TB and HIV clinical trials and research programs
impacted by U.S. government funding disruptions, and proposes urgent actions that
donor agencies, governments, and philanthropies can take to preserve scientific advances
underway and prevent the collapse
...
of TB and HIV medical research in South Africa
more
A Training Curriculum for Multidisciplinary Healthcare Teams. This innovative training package aims to empower multidisciplinary health workers to have the confidence and skills to provide comprehensive, youth-friendly HIV services that support adol
...
escents’ healthy development, psychosocial well being, retention, adherence, sexual and reproductive health, and eventual transition to adult HIV services.
more
The curriculum, which complements the national pediatric ART training, was finalized in 2011 and was subsequently implemented nationally. The training curriculum includes a 15-module Trainer Manual, a Participant Manual, and accompanying PowerPoint slides.
With this quick reference guide, providers can easily recognize diseases and side effects related to climate change, implement appropriate management and provide guidance to exposed populations, provide up-to-date information on the relationship between the adverse effects of certain drugs and the w
...
orsening of climate-sensitive health conditions, and determine the possible consequences of climate change for health services. This book addresses key meteorological risks, as well as the health conditions which they may influence, grouped by specific clinical areas.
more
The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly c
...
ost-effective and improves effectiveness of core public health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
more
We investigate whether and to what extent Chinese development finance affects infant mortality, combining 92 demographic and health surveys (DHS) for a maximum of 53 countries and almost 55,000 sub-national locations over the 2002-2014 period. We ad
...
dress causality by instrumenting aid with a set of interacted variables. Variation over
time results from indicators that measure the availability of funding in a given year. Cross-sectional variation results from a sub-national region’s “probability to receive aid.” Controlled for this probability in tandem with fixed effects for country-years and provinces, the interactions of these variables form powerful and excludable instruments. Our results show that Chinese aid increases infant mortality at sub-national scales, but decreases mortality at the countrylevel. In several tests, we show that this stark contrast likely results from aid being fungible within recipient countries.
more
The booklet starts with a general overview of how illicit drugs and the environment are linked within the bigger picture of the Sustainable Development Goals, climate change and environmental sustainability. It highlights direct and indirect linkages and gives examples of the significant local and i
...
ndividual-level impact that drugs can have on the environment. This is followed by a more in-depth overview of the latest scientific evidence for plant-based drugs and for synthetic drugs. For plant-based drugs, for example, this includes an analysis of the relationship between illicit crop cultivation and deforestation. For synthetic drugs, it includes an analysis of waste composition, volumes, and dumping and discharge, as well as the relation with wastewater treatment.
more
AJOL, Vol.92 No.2; There is a low bed capacity in ICUs compounded by a universal deficit in human resource capacity and support infrastructure for the critical care services. Regionalisation, increased funding and more training opportunities for critical are
services by the regional and central go
...
vernments will go a long way in alleviating these challenges
more
Transformation and outlook
