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A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno Distr

Wroe, E.B.; Nhlema, B.; Dunbar, E.L. et al. BMJ Global Health (2021) CC

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan... more

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Community Health Worker Training Curriculum - Facilitator's Guide

Baylor Tingathe Community Outreach Programme Baylor College of Medicine Children’s Foundation Malawi (2016) CC

This curriculum was designed to train newly recruited health care workers (HCW) in the basic knowledge and skills needed to improve different HIV services within the health facility including identification, linkage, retention and support. In addition to HIV basics, the training has supplementary un... more

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Summary of National Priorities - Malawi

Community Health Roadmap United States Agency for International Development; Bill & Melinda Gates Foundation; The Rockefeller Foundation; World Bank Group; community health acceleration partnership; unicef (2021) CC

Malawi’s first National Community Health Strategy (NCHS, 2017-2022) defines a new community health system in which community health cadres, both formal and non-formal, deliver services of the Essential Health Package, with a focus on child and maternal health. It envisages an integrated approach t... more

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Community Health Roadmap - Malawi

Community Health Roadmap (2018) CC

Community Health: Malawi is in the process of implementing its first-ever National Community Health Strategy (NCHS, 2017-2022); the NCHS is embedded in the Health Sector Strategic Plan (HSSPII) and the community health workforce includes both formal and non-formal cadres

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Moving to a strong(er) community health system: analysing the role of community health volunteers in the new national community health strategy in Malawi

Angwenyi, V.; Aantjes, C.; Kondowe, K. et al. BMJ Global Health (2018) CC

Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue... more

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National Community Health Strategy 2017-2022

Government of the Republic of Malawi (2017) CC

The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the provision of basic health services in rural and urban communities with the participation of people who live there. Historically, Community Health has significantly contributed to im... more

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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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The role of community health workers in influencing social connectedness using the household model: a qualitative case study from Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M. et al. Global Health Action (2022) CC

Community health workers (CHWs) play a vital role in facilitating social connectedness, building trust, decrease stigma, and link communities to essential healthcare and social support services. More studies are needed to understand the factors facilitating these interactions among CHWs, clients, an... more