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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 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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Report of the workshop for implementing the WHO South-East Asia Regional NCD Roadmap, 2022-2030 WHO

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

The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca... more

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The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health

Vaduganathan, M.; Mensah, G.A.; Turco, J.V. et al. Journal of the American College of Cardiology (2022) CC

Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a... more

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World Heart Federation Roadmap for Hypertension – A 2021 Update

Jemoon, P.; Séverin, T.; Amodeo, C. et al. Global Heart (2021) CC

The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca... more

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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

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Implications of the Marburg virus disease outbreak in Rwanda for the EU/EEA, 2024

European Centre for Disease Prevention and Control (ecdc) (2024) C_CDC

This threat assessment addresses the implications of the ongoing Marburg virus disease (MVD) outbreak in Rwanda for the European Union/European Economic Area (EU/EEA). MVD is a severe disease in humans and, although uncommon, it has the potential to cause epidemics with significant case fatality. ... more

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The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project

Kirenga, B.J.; Chakaya, J.; Yimer, G. et al. Journal of Allergy and Clinical Immunology: Global (2024) CC

Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence, mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethio... more

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The Global Burden of Disease Study at 30 years

Murray, C.J.L. nature medicine (2022) CC

The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases... more

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Operational guidance on the use of yellow fever assays in the context of surveillance

World Health Organization WHO (2023) C_WHO

This publication aims to provide updated guidance on the specific use of yellow fever laboratory assays in the context of surveillance to be used across the Global Yellow Fever Laboratory Network for disease surveillance. In the recent years, new commercial assays became available and are now recomm... more

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The Case for the Digital Transformation of Circulatory Health

World Heart Federation (2020) CC

This paper explores the angles and opportunities of digital health, with a look at digital innovation and its potential to support patients with circulatory diseases. In reviewing developments in the field, current applications as well as gaps, the paper aims to support policymakers in leveraging ... more

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Empowering Frontline Primary Healthcare Workers in a Global Health Partnership Training of Trainers Intervention to Strengthen the Prevention and Control of Cardiovascular Disease in Mozambique

Harris. P.; Juga, E.; Bay, N. et al. Global Heart (2022) CC

Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t... more

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Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

Cooper, P. J.; Figueiredo, C. A.; Rodriguez, A.; et al. (2023) CC2

Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r... more

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Supported self-management for asthma

Hinnock, H. Breathe (2015) CC

This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management for asthma and suggests an appropriate strategy for implementing supported self-management.

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The reality of managing asthma in sub-Saharan Africa – Priorities and strategies for improving care

Mortimer, K.; Masekela, R.; Ozoh, O.; et al. (2022) CC2

Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati... more

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2020 Brazilian Thoracic Association recommendations for the management of asthma

Menezes Pizzichini, M. M.; de Carvalho-Pinto, R. M.; Delfini Cançado, J. E.; et al. (2020) CC2

The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... more

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The missing link: Rethinking and reprioritizing HIV and gender-based violence in fragile settings

UNAIDS (2024) CC

This report explores the extent to which evidence, policy, normative guidance and commitments on HIV and gender-based violence, and their interlinkages, is being translated into action on the ground in fragile settings. These issues are explored through the lens of training of peace support operatio... more

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Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa

Mphahlele, R.; Lesosky, M.; Masekela, R. BMJ Open Respiratory Research (2023) CC

Background Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris... more

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International study of asthma and allergies in childhood (ISAAC): rationale and methods

Asher, M.I.; Keil, U.; Anderson, H.R. European Respiratory Journal (1995) CC

he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m... more

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Ensuring quality health care by reducing HIV-related stigma and discrimination

World Health Organization WHO (2024) C_WHO

Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obliga... more