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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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Sexual and Reproductive Health and Rights (SRHR) Policy 2017-2022

United Nations Population Fund UNFPA, Ministry of Health Malawi Ministry of Health Malawi (2017) CC

The revision of the SRHR Policy is based on the results of the analysis of the implementation process of the past policy, which has provided evidence to ensure that the revised policy is relevant and effective. The revision has also been done with the participation of all national stakeholders who ... more

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Antimicrobial resistance and primary health care

World Health Organization WHO (2018) C_WHO

Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse a... more

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Research for universal health coverage: World health report 2013

World Health Organization (2013) C_WHO

Universal health coverage ensures everyone has access to the health services they need without suffering financial hardship as a result. In December 2012, a UN resolution was passed encouraging governments to move towards providing universal access to affordable and quality health care services. As ... more

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Guidance on mainstreaming biodiversity for nutrition and health

World Health Organization WHO (2020) C_WHO

This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to: Consider... more

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Community Health Volunteers' Decision Support System Project

P. Bakibinga, Kamande E. , Kisia L., et al. African Population and Health Research Centre APHRC (2018) C1

This report presents the key findings of the end-of-project assessment of households and community health volunteers, conducted in 2017 in the Kamukunji and Embakasi sub-counties of Nairobi, Kenya, for a Community Health Volunteers’ Decision Support System (CHV DSS) intervention project. The re... more

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Investing in Mental Health: Evidence for Action

World Health Organization WHO (2013) C_WHO

In this report, potential reasons for this apparent contradiction between cherished human values and observed social actions are explored with a view to better formulating concrete steps that governments and other stakeholders can take to reshape social attitudes and public policy.

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Analysing and using routine data to monitor the effects of COVID-19 on essential health services: practical guide for national and subnational decision-makers

World Health Organization WHO (2021) C_WHO

14 January 2021 This practical guide can be used to help countries monitor and analyse the impact of COVID-19 on essential health services to inform planning and decision-making. It provides practical recommendations on how to use key performance indicators to analyse changes in access to and deliv... more

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Three models of community mental health services In low-income countries

A. Cohen, J. Eaton, B. Radtke, et al. (2011) CC

International Journal of Mental Health Systems December 2011, 5:3 Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse serv... more

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Ensuring health security in the African region - Emergency preparedness and response flagship programmes

World Health Organization WHO, Regional Office of Africa (2022) C_WHO

The World Health Organization Regional Office for Africa (WHO AFRO), in accordance with recommendations from various WHO committees, has developed three flagship programmes to support Member States in the African region to prepare for, detect and respond to public health emergencies. They are the re... more

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Assessment Instrument for Mental Health Systems

World Health Organization WHO (2005) C_WHO

1. Provide treatment for mental disorders in primary care 2. Ensure wider accessibility to essential psychotropic drugs 3. Provide care in the community 4. Educate the public 5. Involve communities, families and consumers 6. Establish national policies, programmes and legislation on mental heal... more

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Measures to strengthen primary health-care systems in low- and middle-income countries

Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey World Health Organization (2020) C_WHO

Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar... more

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National Health- Care Waste Management Plan 2015-2019

Ministry of Health, Zambia (2015) C1

This document has been developed as a guide to allinstitutions producing health care waste in planning and implementation of interventions that will reduce mismanagement of hazardous waste in Zambia.The National Health-Care Waste Management Plan for 2015 to 2019 provides an overv... more

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Pregnant adolescents and nurses perspectives on accessibility and utilization of maternal and child health information in Ohangwena Region, Namibia

Shatilwe, J. T.; Hlongwana, K.; Mashamba-Thompson, T. P. (2022) CC2

BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child heal... more

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Humanitarian development peace nexus for health profile: Yemen, October 2020

World Health Organization WHO (2021) CC

The humanitarian-development-peace nexus (‎HDPNX)‎ is a new way of working that offers a framework for coherent joined-up planning and implementation of shared priorities between humanitarian development and peacebuilding actors in emergency settings. To advance the HDPNx in a given country a sh... more

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Ways out of the global health crisis

Seitz, K. Misereor, Brot für die Welt, Global Policy Forum GPF (2021) C1

Healthy people, healthy animals and a healthy environment worldwide with the One Health approach. The COVID-19 pandemic has drastically demonstrated just how close the link is between humans, animals, and the environment, and has highlighted and aggravated existing challenges. The destruction of na... more

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Health workers’ adoption of digital health technology in low- and middle-income countries: a systematic review and meta-analysis

World Health Organization WHO (2025) C_WHO

Digital health technology can make health systems more efficient and sustainable, facilitating the provision of high-quality care across a wide range of contexts and for diverse population health needs. The pace of innovation in digital health is rapid and constant, with new interventions bein... more

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Humanitarian Health Ethics Analysis Tool: HEAT Handbook

Fraser V, Hunt MR, Schwartz L, and de Laat S (2014)

You can download the handbook, worksheets and quick reference cards from the website! The HHEAT is an ethical analysis tool designed to help humanitarian healthcare workers make ethical decisions. It consists of 3 components: (1) a summary card highlighting key questions, (2) a handbook providing a... more

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Rwanda: National Human Resources for Health Policy

Ministry of Health, Rwanda (2014) C2

The Human Resources for Health policy (HRH) will provide guidelines and the direction toward strengthening the planning, management, utilization and monitoring of health sector human resources; not forgetting responses to the contemporary challenges and developments in the sector including the mobil... more

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International Health Regulations (2005) and chemical events

World Health Organization (2015) C_WHO

In 2005, the World Health Organization (WHO) Member States adopted the revised International Health Regulations (IHR) (2005). The Regulations provide a unique public health framework in the form of obligations and recommendations that enable countries to better p... more