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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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Enhancing Pharmacovigilance in Sub‑Saharan Africa Through Training and Mentoring: A GSK Pilot Initiative in Malawi

Jusot, V.; Chimimba, F.; Dzabala, N. et al. Drug Safety (2020) CC

Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV. Objective The objective of this initiative was to improve reporting of adverse events (A... more

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Hypertension in adults: diagnosis and management

the National Institute for Health and Care Excellence (NICE) the National Institute for Health and Care Excellence (NICE) (2023) CC

The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di... more

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Intention to action series: Regional reflections. Analysis from informal regional consultations with people living with noncommunicable diseases and mental health conditions 2023 WHO

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

This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit... more

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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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Guidance on global monitoring for diabetes prevention and control: Framework, indicators and application

World Health Organization WHO (2024) C_WHO

The Guidance on global monitoring for diabetes prevention and control by WHO provides a comprehensive framework to support countries in tracking and managing diabetes prevention, care, and outcomes. This document outlines indicators across 4 domains: health system determinants, service delivery, ris... more

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Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 1: conducting a comprehensive assessment

World Health Organization (WHO) World Health Organization (WHO) (2022) C_WHO

One of the first steps in developing a multisectoral action plan (MSAP) is to use a situation analysis to provide a comprehensive assessment of the health needs, prevailing risks and the context of the area to which the plan will apply. This will help countries, regions, provinces or cities intendi... 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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The ISN framework for developing dialysis programs in low-resource settings

International Society of Nephrology (2021) CC2

Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable diseases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over... more

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Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors 2023

World Health Organization WHO (2023) C_WHO

The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys... more

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Module for Multi-Purpose Workers (MPW) - Female/Male on Prevention, Screening and Control of Common Non-Communicable Diseases

National Health Mission; Minister of Health and Family Welfare Government of India (2024) CC2

This module covers common Non-Communicable Diseases such as Hypertension, Diabetes and three common cancers (Cervical, Breast and Oral cancer). The focus of this module is on building the knowledge and skills of the Multi-Purpose Workers (MPW) in undertaking Population Based Screening, identifi ca... more

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A cross-country qualitative analysis of teachers’ perceptions of asthma care in sub-Saharan Africa

Naidoo, K.L.; Dladla, S.; Mphahlele, R.E. et al. npj Primary Care Respiratory Medicine (2023) CC2

Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions... more

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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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Social capital insights from Healthy Settings needs assessment in Malawi

Rippon, S.; Beattie, T. K.; Lungu, K.; et al. (2018) CC2

Healthy Settings, a key component of Malawi’s Health Sector Strategic Plan (HSSP) 2011–2016, is the World Health Organization’s (WHO) holistic community-led approach to achieving health improvement by addressing social determinants of health, an approach which is central to the current WHO fra... more

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Prioritised research agenda for prevention and control of chronic respiratory diseases

Bousquet, J.; Kiley, J.; Bateman, E.D. European Respiratory Journal (ERJ) (2010) C_WHO

The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including... more

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Management of diabetes A national clinical guideline

Helthcare Improvement Scotland (2017) CC2

Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a... more

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Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update

Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al. African Journal of Thoracic and Critical Care Medicine (2021) CC

sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ... more

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Trauma induced disorders and Post-Traumatic Stress Disorder (PTSD)

Ethno-Medizinisches Zentrum e. V. (2015) C1

This guide aims to inform about these illnesses - so-called ‘trauma-induced disorders’ - in general and ‘post-traumatic stress disorder’ (PTSD) in particular. It is also designed to offer support in finding treatment and counselling options.

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Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia

Adler, A.J.; Trujillo, C.; Schwartz, L.; et al. BMJ Journals (2021) CC

While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng... more

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Integrated operational framework for mental health, brain health and substance use

World Health Organisation (WHO) (2024) C_WHO

This integrated operational framework provides an overview of the connections between mental health, neurological and substance use (MNS) conditions, and their links to health, well-being and the broader public health and sustainable development agenda. The need for integrated approaches is increasi... more