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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

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

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

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

Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al. BMC Health Services Research, part of Springer Nature (2023) CC2

Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th... more

Sharing successful strategies from the Eastern Mediterranean Region in mitigating noncommunicable diseases and mentalhealth disorders during the COVID-19pandemic and beyond

World Health Organization (WHO) Regional Office for the Eastern Mediterranean World Health Organization (WHO) Regional Office for the Eastern Mediterranean (2023) C_WHO

The "Stories from the field" document by the WHO Regional Office for the Eastern Mediterranean shares effective strategies from the Eastern Mediterranean Region for addressing noncommunicable diseases (NCDs) and mental health challenges, particularly during the COVID-19 pandemic. It highlights regio... more

WHO package of essential noncommunicable (PEN) disease interventions for primary health care

World Health Organization (WHO) World Health Organization (WHO) (2020) C_WHO

The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Designed ... more

Burden of fungal asthma in Africa: A systematic review and meta-analysis

Kwizera, R.; Musaazi, J.; Meya, D.B.; et al. PLOS ONE, which is part of the Public Library of Science (PLOS) (2019) CC2

Asthma is one of the neglected diseases in Africa with a high prevalence. Allergic fungal diseases have been reported to complicate asthma progression and treatment outcomes. However, data about fungal asthma and its associated complications are limited in Africa. We aimed to estimate the burden of ... more

Barriers to childhood asthma care in sub-Saharan Africa: a multicountry qualitative study with children and their caregivers

Naidoo, K.L.; Dladla, S.; Mphahlele, R.E. et al. BMJ Open (2023) CC

This study identifies barriers and provides recommendations to improve asthma care in children across sub-Saharan Africa, where qualitative data is lacking despite high rates.

Challenges in the diagnosis of asthma in children, what are the solutions? A scoping review of 3 countries in sub Saharan Africa

Magwenzi, P.; Rusakaniko, S.; Sibanda, E.N. et al. Respiratory Research (2022) CC

The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir... more

The Burden of Pediatric Asthma

Ferrante, G.; La Grutta, S. Frontiers in Pediatrics (2018) CC

Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa... more

Monitoring asthma in children

Pijnenburg, M.W.; Baraldi, E.; Brand, P.L. et al. European Respiratory Journal (2015) CC

The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i... more

The National Asthma Education Programme and asthma in Africa

South African Medical Journal; SAMJ (2019) CC2

The National Asthma Education Programme (NAEP) is a registered non-profit organisation whose mission is to provide asthma education to healthcare professionals, patients and the lay public. It was founded in 1994 by Dr Mike Greenblatt and Profs Dave Luyt and Robin Green. This year NAEP celebrates it... more

A summary of the new GINA strategy: a roadmap to asthma control

Reddel, H. K.; Bateman, E. D.; Becker, A.; et al. (2015) CC2

Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r... more

2023 GINA Main Report, Global Strategy for Asthma Management and Prevention

Global Institute for Asthma (2023) CC2

The 2023 update of the Global Strategy for Asthma Management and Prevention incorporates new scientific information about asthma based on a review of recent scientific literature by an international panel of experts on the GINA Science Committee. This comprehensive and practical resource about one o... more

Global Strategy for Asthma Management and Prevention (2022 update)

Global Initiative for Asthma (2022) CC2

The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi... more

Global Strategy for Asthma Management and Prevention (2019 update)

Global Initiative for Asthma (2019) CC2

Proposed Strategies to Improve Adult Asthma Management in Egypt: Expert Review and Recommendations

Hosny, H.; Madkour, A.; Hantera, M.; et al. (2022) CC2

Several challenges face asthma management in Egypt, including the high percentage of uncontrolled patients, inadequate compliance, and overuse of short-acting beta-agonists (SABAs) leading to increased asthma-related morbidity and mortality. In this regard, the recent Global Initiative for Asthma (G... more

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

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