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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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Renewable energy solutions improve children’s health and wellbeing in Malawi

Unicef (2021) C_UNICEF

UNICEF Malawi and its partners are prioritizing renewable energy solutions for children and communities across the country to access clean and affordable electricity, with a focus on hard-to-reach, rural communities unable to access the national electricity grid.

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Ready to Use Therapeutic Food (RUFT) and the WHO Essential Medicines List

CMAM Forum (2018) CC

Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist yet sadly approximately only 3.2 million children with SAM have access to treatme... more

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The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study

Khuluza, F.; Haefele-Abah, C. PLoS ONE (2019) CC

The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... more

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Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al. BMC Health Services Research, part of Springer Nature (2023) CC2

Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th... more

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Multi-country outbreak of mpox, External situation report #42- 9 November 2024

World Health Organisation (WHO) (2024) C_WHO

This is the 42nd situation report for the multi-country outbreak of mpox, which provides an update on the epidemiological situation of mpox in Africa (including countries in the WHO African Region and some countries in the WHO Eastern Mediterranean Region), with data as of 3 November 2024.

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Sexual, reproductive, maternal, newborn, child and adolescent health: report on the 2023 policy survey

World Health Organisation (WHO) (2024) C_WHO

Evidence- and rights-based national policies, guidelines and legislation play a key role in improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH), framing the enabling environment for equitable provision and accessibility of quality services. The SRMNCAH policy sur... more

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Sustainable management of radiotherapy facilities and equipment

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

The document, "Sustainable Management of Radiotherapy Facilities and Equipment," by WHO and IAEA, provides guidelines for managing radiotherapy equipment and facilities to ensure effective and safe cancer treatment. It covers essential aspects like preventive and corrective maintenance, funding, inf... more

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Advancing the global agenda on prevention and control of noncommunicable diseases 2000 to 2020

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

This document highlights landmarks and key milestones in the development and implementation of the global agenda for noncommunicable diseases (NCDs) over the last two decades. It summarizes where the world was in 2000, where it is in 2022, and where the world wants to be in terms of NCD prevention a... more

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Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub... more

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WFP Malawi Country Brief, April 2022

World Food Programme (2022) CC

Malawi is a small landlocked country in Sub-Saharan Africa with a population expanding rapidly at 3 percent per year. With most livelihoods dependent on rainfed agriculture, the population is highly vulnerable to the effects of natural disasters, prolonged dry spells and flash floods.

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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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Социальное и психическое здоровье пожилых женщин как часть стратегии спасения людей: Новые вызовы для социальной работы

O. A. Anikeeva, S. N. Fomina, Ya. V. Shimanovskaya (2021) C1

Стратегия народосбережения в Российской Федерации — один из основных документов государственной социальной политики. Она может быть реализована различными путя... more

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Strengthening health systems to improve the health of displaced and migrant populations in the context of climate change Evidence brief

World Health Organisation (WHO) (2024) C_WHO

The WHO Global research agenda on health, migration and displacement identified the health of displaced and migrant populations in the context of climate change as one of the most pressing, yet under-researched, topics.

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Dolutegravir Resistance in Malawi’s National HIV Treatment Program

van Ossterhout, J. J.; Chipungu, C.; Nkhoma, L. et all. (2022) CC2

Dolutegravir HIV drug resistance (HIVDR) data from Africa remain sparse. We reviewed HIVDR results of Malawians on dolutegravir-based antiretroviral therapy (November 2020– September 2021). Of 6462 eligible clients, 33 samples were submitted to South Africa, 27 were sequenced successfully, and 8 ... more

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CVD and the Development Agenda: Advocacy Toolkit

World Heart Federation (2017) CC

Global Development: Where Are We Now? Today, we are facing a vital opportunity to change the profile of cardiovascular disease around the world. The Millennium Development Goals (MDGs) are due to expire at the end of 2015, placing the cardiovascular health community in a unique position to shape t... more

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Population and Individual Approaches to the Prevention and Management of Diabetes and Obesity

Pan American Health Organization PAHO (2011) C_WHO

Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and one-fi fth of adolescents are obese, while rates of overweight and obe... more

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Kenya National Guidelines for Cardiovascular Diseases Management

Ministry of Health Kenya Republic of Kenya (2018) CC

The Kenya Health Policy 2014-2030 aims at attaining the highest possible standard of health in a manner responsive to the health needs of our population. One of the major policy directions towards realizing the intentions of this policy is to halt and reverse the rising burden of non-communicable d... more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Associations of the built environment with type 2 diabetes in Asia: a systematic review

Aarthi, G.R.; Begum, T. S. M.; Al Moosawi, S.; et al. BMJ Open (2023) CC2

Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia.