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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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Renewable energy solutions improve children’s health and wellbeing in Malawi

Unicef (2021) C_UNICEF

UNICEF Malawi and its partners are prioritizing renewable energy solutions for children and communities across the country to access clean and affordable electricity, with a focus on hard-to-reach, rural communities unable to access the national electricity grid.

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Social protection programmes in Malawi

Government of Malawi; Unicef (2022) C_UNICEF

Social protection programmes in Malawi ensure that those most in need get the essential assistance they require.Social protection programmes help the most vulnerable, including the elderly, ultra-poor, disabled, and children

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Poliovirus Outbreak Response (WPV1) Malawi

Public Health Institute of Malawi; Polio Global Eradication Initative; World Health Organization; Unicef (2022) C_WHO

On 16 February 2022, Malawi received confirmation of Wild Poliovirus Type 1 (WPV1) from an acute flaccid paralysis (AFP) case in Lilongwe.

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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

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Access to health care for people with disabilities in rural Malawi: what are the barriers?

Harrison, J.A.K.; Thomson, R.; Banda, H.T. et al. BMC Public Health (2020) CC

People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi... more

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Disability inclusive employment in urban Malawi: A multi-perspective interview study

Remnant, J.; Wånggren, L.; Huque, S. et al. Journal of International Development (2022) CC

The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with... more

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Do Disability Inequalities Grow with Development? Evidence from 40 Countries

Lewis, E.; Mitra, S.; Yap, J. Sustainability (2022) CC

With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across countries by development level. Using internatio... more

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Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan

Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al. International Journal for Equity in Health (2021) CC

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Met... more

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Integrated home-based screening for people living with disabilities: A case study from rural Malawi

Petersen, E.M.; Wroe, E.B.; Nyangulu, K. et al. African Journal of Disability (2019) CC

People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. Th... more

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Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions

Prynn, J.E.; Dube, A.; Mwaiyeghele, E. et al. Wellcome Open Research (2022) CC

Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of co... 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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Ready to Use Therapeutic Food (RUFT) and the WHO Essential Medicines List

CMAM Forum (2018) CC

Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist yet sadly approximately only 3.2 million children with SAM have access to treatme... more

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The availability, cost, and affordability of essential medicines for asthma and COPD in low-income and middle-income countries: a systematic review

Stolbrink, M.; Thomson, H.; Hadfield, R.M. et al. The Lancet Global Health (2022) CC

Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity and mortality in low-income and middle-income countries (LMICs). Access to safe, effective, quality-assured, and affordable essential medicines is variable. We aimed to review the existing ... 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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The Malawi Growth and Development Strategy (MGDS) III (2017-2022)

Government of Malawi (2017) CC

The third Malawi Growth and Development Strategy (MGDS III) has been formulated following the expiry of its predecessor strategy, MGDS II, in June 2016. The strategy has been prepared at a time when Malawi has been experiencing multiple shocks including floods, drought and financial crises. While fo... more

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Malawi National Communication and Advocacy Strategy for Pre-Exposure Prophylaxis (PrEP)

United States Agency for International Development; President's Emergency Plan for AIDS Relief; National AIDS Commission MAlawi (2022) CC

Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in ... more

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The investment case for social protection in Malawi

Ministry of Gender, Children and Community Development; Unicef (2022) C_UNICEF

There has been a rapid expansion of cash-based, social protection programmes in sub-Saharan Africa (SSA) in recent years as Governments increasingly realise the enormous benefits cash transfers offer (World Bank, 2018). In fact, as an investment in human capital and inclusive economic development, ... more

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The Malawi Noncommunicable Diseases & Injuries Poverty Commission Report

Republic of Malawi; Ministry of Health (2018) CC2

As our world changes, so too does the burden of disease. Globalisation, evolving trade and consumption patterns, and increased access to life-saving medical care are just some of the factors that have transformed the global health landscape.