This content is from the Advance Chapters of the NEW Where There Is No Doctor. You can download this chapter in Bangla, English, Haitian Kreyol, Lao, Nepali, Spanish, and Swahili
Report
A Project of the Joep Lange Institute July, 2018
This document provides guidance to African Union Member States on key mental health and psychosocial support (MHPSS) considerations in relation to the coronavirus disease 2019 (COVID-19) pandemic. It contains useful guidance on MHPSS for the community, healthcare workers, caregivers of vulnerable po...pulations and people in quarantine, isolation or treatment centers(1)
(2). This guidance aims to provide practical steps to reduce stress, anxiety, stigma and psychological disorders associated with COVID-19 and improve overall mental health and well being. This guidance can be used for planning purposes by policy makers and Ministries of
health and institutions coordinating emergency response to COVID-19 response by Member States. It can also be disseminated to stakeholders.
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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.
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Rapport sur les populations clés.
the Lancet : Published Online July 31, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61117-5
Policy
June 2015
Training Menus, Facilitation Tips, and Participatory Training Modules
Framework of Indictors and Targets
Guidelines for Primary, Secondary and Tertiary Level Care