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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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Access to health care for people with disabilities in rural Malawi: what are the barriers?

Harrison, J.A.K.; Thomson, R.; Banda, H.T. et al. BMC Public Health (2020) CC

People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi... more

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The adolescent health indicators recommended by the Global Action for Measurement of Adolescent Health: Guidance for monitoring adolescent health at country, regional and global levels

UN Children's Fund UNICEF; UN Educational, Scientific and Cultural Organization UNESCO; UN Women; UNAIDS; United Nations Population Fund UNPF; World Bank; World Food Programme WFP; World Health Organization WHO (2024) C_WHO

Adolescence is a critical stage in life for physical, cognitive and emotional development, shaping future health and well-being. Comprehensive measurement of adolescent health is essential to prioritize health issues, guide interventions and track progress. However, global, regional and national ado... more

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SEAHEARTS Monitoring Framework

World Health Organisation (WHO) (2024) C_WHO

Monitoring Framework

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WHO package of essential noncommunicable (PEN) disease interventions for primary health care

World Health Organization (WHO) World Health Organization (WHO) (2020) C_WHO

The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Designed ... more

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How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola or Marburg virus disease

World Health Organization WHO (2014) C_WHO

This protocol provides information on the safe management of dead bodies and burial of patients who died from suspected or confirmed Ebola or Marburg virus disease. These measures should be applied not only by medical personnel but by anyone involved in the management of dead bodies and burial of su... more

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Asbestos-related diseases in mineworkers: a clinicopathological study

Ndlovu, N.; Rees, D.; Murray, J.; et al. ERJ Open Research, part of the European Respiratory Society (ERS) (2017) CC

This study compared clinical and autopsy findings for three asbestos-related diseases (asbestosis, mesothelioma and lung cancer) in former asbestos mineworkers, and explored factors that influenced agreement between clinical and autopsy findings using data from two compensation systems. In South Afr... more

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Open Access Re-envisioning Kangaroo Mother Care Implementation Through a Socioecological Model: Lessons From Malawi

Global Health: Science and Practice (2022) CC2

Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We aimed to better understand social norms and commun... more

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ICMR Guidlines for management of type 2 Diabetes

Indian Council of Medical Research (2018) CC2

In recent decades, India has witnessed a rapidly exploding epidemic of diabetes. Indeed, India today has the second largest number of people with diabetes in the world. The International Diabetes Federation (IDF) estimates that there are 72.9 million people with diabetes in India in 2017, which is... more

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Hypertension - Screening, Diagnosis, Assessment, and Management of Primary Hypertension in Adultd in India

Ministry of Health & Family Welfare India Government of India (2017) CC

Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven ... more

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Prevention of Cardiovascular Disease: Guidelines for assessment and management of cardiovascular risk

World Health Organization WHO (2007) C_WHO

Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera... more

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HEARTS. Technical package for cardiovascular disease management in primary health care. Evidence-based treatment protocols

World Health Organization WHO, et al. (2018) C_WHO

In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles... more

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HEARTS. Technical package for cardiovascular disease management in primary health care. Systems of Monitoring

World Health Organization WHO, et al. (2018) C_WHO

Monitoring is a crucial element in any successful programme. It is important to know if health care facilities – and ultimately countries – are meeting the agreed goals and objectives for preventing and managing cardiovascular diseases (CVD). Monitoring is the on-going collection, management ...and use of information to assess whether an activity or programme is proceeding according to plan and/ or achieving defined targets. Not all outcomes of interest can be monitored. Clear outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met. To allow progress to be monitored, this module provides a set of indicators on CVD management. Agreeing on a set of indicators allows countries to compare progress in CVD management and treatment across different districts or subnational jurisdictions, as well as at a facility level, identify where performance can be improved, and track trends in implementation over time. Monitoring these indicators also helps identify problems that may be encountered so that implementation efforts can be redirected. This module starts from the collection of data at facility level, which is then “transferred up” the system: facility-level data are aggregated at subnational level to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys. Implementing a monitoring system requires action at many levels. At national and subnational levels, staff can determine how best to integrate data elements into existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS). In the facility setting, personnel must be aware of what data are needed. Sample data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools more

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Engaging health and care workers in health emergencies: implementation toolkit

World Health Organisation (WHO) (2024) C_WHO

The active participation and engagement of health and care workers (‎HCWs)‎ in health emergency preparedness, readiness and response is crucial to support risk communication, community engagement and infodemic management (‎RCCE-IM)‎ interventions during emergencies. HCWs hold unique position... more

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National User Guide on the Prevention and Treatment of Hypertension in Adults at the PHC Level 2021

Health Department: Republic of South Africa (2021) CC

Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated with a number of conditions, disability, and causes o... more

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Global Strategy for Asthma Management and Prevention (2019 update)

Global Initiative for Asthma (2019) CC2

The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi... more

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Cervical Cancer Prevention and Control Policy (South Africa)

Dept. of Health, Republic of South Africa (2021) C1

Cervical cancer, along with maternal deaths, has been identified as a national priority in South Africa as well as other Sub-Saharan African countries. Cervical cancer is the second most common cancer among women in South Africa, after breast cancer. Due to limited access to prevention, early dia... more

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Global report on hypertension: the race against a silent killer
recommended

World Health Organisation (WHO) (2023) C_WHO

This report compiles data for the first time on the far-reaching consequences of uncontrolled hypertension, including heart attacks, strokes and premature death, along with substantial economic losses for communities and countries. It also contains information on the global, regional and country-lev... more

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Global report on children with developmental disabilities

World Health Organisation (WHO) (2023) C_WHO

Developmental disabilities are common. Yet, children with developmental disabilities have been neglected in health systems planning and policy provisions for health and continue to experience stigmatization, institutionalization, barriers to access health care and inequalities in health and educatio... more

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A Compendium of Tools and Methods to Address Social Inequities Affecting the Health and Well-being of Women, Children, and Adolescents in Latin America and the Caribbean

Pan American Health Organization (PAHO) (2023) C_WHO

To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of equity and evidence-based policies, strategies and interventions to accelerate equitable progress in ... more

Global report on hypertension: the race against a silent killer recommended

Global report on hypertension: the race against a silent killer
recommended