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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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Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan

Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al. International Journal for Equity in Health (2021) CC

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Met... more

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Diabetes and Ramadan: Practical guidelines 2021

Hassanein M., Afandi B. et al. Diabetes Research and Clinical Practice (2016) CC2

The document "Diabetes and Ramadan: Practical Guidelines 2021," published by Elsevier, provides updated guidance for managing diabetes during Ramadan fasting. Developed by the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance, the guidelines address ke... more

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Prediabetes Risk Test

adapted from Bang et al., Ann Intern Med (2009) American Diabetes Association in collaboration with the Centers for Disease Control and Prevention (CDC) (2024) CC2

The "Prediabetes Risk Test" is a tool designed to help individuals assess their risk for prediabetes and type 2 diabetes. The test uses a point-based system with questions about age, gender, family history of diabetes, history of high blood pressure, physical activity level, and weight category. Bas... more

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Breast and cervical cancer screening services in Malawi: a systematic review

Pittalis, C.; Panteli, E.; Schouten, E. et al. BMC (2020) CC2

To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness. Systematic review of published scientific evidence. A search of six bibliographic databases and gre... more

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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

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Selection of essential medicines for the prevention and treatment of cardiovascular diseases in low and middle income countries

Bazargani, Y.T.; Ugurlu, M.; Leufkens, H.G.M. et al. BMC Cardiovascular Disorders (2018) CC

The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NE... more

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Asthma management in low and middle income countries: case for change

Mortimer, K.; Reddel, H. K.; Pitrez, P. M.; et al. (2022) CC2

Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma ... more

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Mortality changes after grants from the Global Fund to Fight AIDS, tuberculosis and malaria: an econometric analysis from 1995 to 2010

Yan I.; Korenromp E.; Bendavid E. et al. BMC Public Health (2015) C2

Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20·0%; domestic financing is therefore critical to sustaining the response to HIV/AIDS. To understand whether domestic resources could fill the financing gaps created by declines in development assistance, we aimed to track spe... more

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Tracking donor funding towards achieving the Global Vaccine Action Plan (GVAP) goals: A landscape analysis (1990–2016)

Ilkelezi et al. Department of Global Health; Institute for Health Metrics and Evaluation (2023) CC

Efforts driving universal coverage have recently been strengthened through implementation of the Global Vaccine Action Plan (GVAP) where cost estimates for immunization support were developed totaling US$40 billion of donor assistance by 2020. In addition to resource mobilization, there has been an ... more

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Tracking Japan’s development assistance for health, 2012–2016

Nomura, S.; H. Sakamoto; M. K. Sugai et al. Globalization and Health (2020) CC

: Development assistance for health (DAH) is one of the most important means for Japan to promote diplomacy with developing countries and contribute to the international community. This study, for the first time, estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its... more

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Tracking development assistance for health from China, 2007–2017

Micah et al. BMJ Global Health (2019) CC

In In recent years, China has increased its international engagement in health. Nonetheless, the lack of data on contributions has limited efforts to examine contributions from China. Existing estimates that track development assistance for health (DAH) from China have relied primarily on one data... more

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Sustainable financing mechanisms for strengthening mental health systems in Nigeria

Abdulmalik et al. Pubmed (2019) CC

Background and aims: Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationshi... more

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Training community healthcare workers on the use of information and communication technologies: a randomised controlled trial of traditional versus blended learning in Malawi, Africa

Nikolaos Mastellos, Tammy Tran, Kanika Dharmayat et al. BMC Medical Education (2018) CC

Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The ‘Introduction to Information and ... more

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Exploring the cultural effects of gender on perceptions of cutaneous leishmaniasis: a systematic literature review

Wenning, B., Price, H., Nuwangi, H. et al. Global Health Research and Policy (2022) CC

More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how... more

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A national survey of public awareness of antimicrobial resistance in Nigeria

Chukwu, E., Oladele, D., Awoderu, O. et al. Antimicrobial Resistance & Infection Control (2020) CC

Background: One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public... more

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Taenia solium taeniosis/cysticercosis and the co-distribution with schistosomiasis in Africa

Braae, U.; Saarnak, C.; Mukaratirwa, S. et al. Parasites and Vectors (2015) CC

The major neglected tropical diseases, Taenia solium taeniosis/cysticercosis and schistosomiasis caused by Schistosoma mansoni or S. haematobium are presumed to be widely distributed in Africa. Taenia solium taeniosis/ cysticercosis has been reported as an emerging disease in different regions of Af... more

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Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in the Americas

Braae, U.; Thomas, L.; Roberson, L. et al. Parasites and Vectors (2018) CC

Taenia saginata is a zoonotic tapeworm that is of economic importance in countries where cattle are kept. The parasite is transmitted from human tapeworm carriers (taeniosis) to bovines (cysticercosis) by excretion of eggs or proglottids containing eggs into the environment via the stool. Bovines ca... more

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Elimination of onchocerciasis in Africa by 2025: the need for a broad perspective

Cupp, E.; Sauerbrey, M.; Cama, V. et al. National Library of Medicine (2019) CC

In response to the recent publication “Is onchocerciasis elimination in Africa feasible by 2025: a perspective based on lessons learnt from the African control programmes” by Dadzie et al., it is important to clarify and highlight the positive and unequivocal research and operational contributio... more