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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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Dual HIV/syphilis rapid diagnostic tests can be used as the first test in antenatal care

World Health Organization WHO (2019) C_WHO

Policy Brief. WHO recommends that pregnant women receive testing for HIV, syphilis and hepatitis B (HBSAg) at least once during pregnancy, preferably in the first trimester. Dual HIV/syphilis rapid diagnostic tests (RDTs) can be used as the first test for pregnant women as part of antenatal care (... 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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Diagnosis Prevention and Management of Cryptococcal Disease in HIV-infected Adults and Children

WHO (2011)

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Global AIDS Monitoring 2021 — Regional indicators to measure progress towards zero discrimination — Additional guidance for Latin American and Caribbean countries

World Health Organization WHO (2020) C_WHO

All countries in the Latin American and Caribbean (LAC) region are expected to report on these indicators for the year 2020.

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Swaziland national comprehensive HIV package of care

Kingdom of Swaziland Ministry of Health (2010) C1

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Ethiopia HIV and TB Strategic Information

World Health Organization, Regional Office for Africa CDC (2014) C_WHO

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National Implementation Guidelines for HIV Counselling and Testing in Uganda

Federal Ministry of Health, Uganda (2010) C1

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Zimbabwe National Guidelines on HIV Testing and Counselling

Ministry of Health, Zimbabwe (2005) C1

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Voluntary HIV Counselling and Testing Manual for Training of Trainers - Part 1

Regional Office South-East Asia, World Health Organization (2004) CC

Please download the other parts from the Webseite

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Lesotho HIV policy scan and action plan

Beardsley, Kip., A. Zapfel, and T. Williamson Washington, DC: Palladium, Health Policy Plus (2017) C2

Policy and Legal Opportunities for HIV Testing Services and Civil Society Engagement

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Children and AIDS

Unicef; UNAIDS; World Health Organization; UNFPA (2008)

Third Stocktaking Report, 2008 Unite for Children, Unite against AIDS

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WHO Guidelines Updates on HIV and Infant Feeding

World Health Organization WHO; UNICEF (2016) C_WHO

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Nigeria National AIDS and STIs Control Programme Annual Report 2014

Federal Ministry of Health, Nigeria (2014) C1

Report

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Tuberculosis in HIV/AIDS Patients

Gjergji, M.; j. Bushati; A. Harxkhi, et al. MedGrave (2017) C2

J Epidemiol Infect Dis 1(1): 00003.n DOI: 10.15406/jeid.2017.01.00003 Published: September 14, 2017

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India Country Factsheet: TB and HIV

UNAIDS (2016) C1

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Development and pilot evaluation of a home-based palliative care training and support package for young children in southern Africa

S. N. Naicker; A. Stein; L. Richter; et al. BMC Palliative Care (2016) CC

Naicker et al. BMC Palliative Care (2016) 15:41 DOI 10.1186/s12904-016-0114-7

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Psychosocial counselling and treatment adherence support for people affected by tuberculosis

The Union (2021) C1

The guide is suitable and can be used for the following audiences: 1. nurses and other trained healthcare workers who can use this manual as a self-study tool and then incorporate its guidance into their practice; 2. governmental and non-governmental employers of lay and professional TB treatment ... more

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Liberia HIV & AIDS Response Progress Report April 2016

National AIDS Commission of Liberia (2016) C1

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Compendium of Gender Equality and HIV Indicators

Shelah S. Bloom and Svetlana Negroustoueva MEASURE Evaluation (2013)

The intended purpose of this compendium is to provide program managers, organizations, and policy makers with a menu of indicators to better “know their HIV epidemic/know their response” from a gender perspective. The indicators in the compendium are all either part of existing indicators used i... more