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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary ... 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 maintain 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
PLoSONE 14(9):e0223104.https://doi.org/10.1371/journal.pone.0223104. The survey centering on reasons behind community resistance was conducted in Butembo in November during a time of Ebola transmis... more
This study of Adolescent Boys and Young Men highlights the importance of engaging adolescent boys and young men in sexual and reproductive ... and rights (srhr) and gender equality. This paper establishes a conceptual framework for engaging adolescent boys and young men. It reviews current research on boys’ and young men’s specific risks and realities in relation to their general health status, violence, sexuality and sexual and reproductive health, media violence, sexual exploitation, and other vulnerabilities. more
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with ... aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the literature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children. more
UNICEF analysis indicates that:
- Investments that increase access to high-impact health and nutrition interventions by poor groups have saved almost twice as many lives as equivalent investments in non-poor groups.
- Access to high-impact... more
Novel coronavirus will disproportionately impact world’s 70 million displaced people Report recommends stopping asylum seeker deportations, prioritising hygiene and refugee camp decongestion, better communication Displaced people must be included in prevention, mitigation efforts - for s... more
This document provides a list of key WHO-recommended maternal and newborn health commodities and aims to accelerate progress towards the SDGs. It c... more
PLoS ONE 7(12): e52986. doi:10.1371/journal.pone.0052986. Opern Access please download from the website
This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use ... them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describe decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints. more
This document describes the key areas that national governments should consider for the introduction and scale-up of point-...-care (POC) diagnostics within national programmes, as new innovative POC technologies are being introduced into the market. The next steps taken to include these new innovations within the broader context of national diagnostic networks of conventional laboratories could influence the achievement of the 2030 Fast Track targets for ending the AIDS epidemic.
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa. more
Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trend... more

Social determinants of mental health

Fundação Calouste Gulbenkian World Health Organization WHO (2014) C_WHO
Good mental health is integral to human health and well being. A person’s mental health and many common mental disorders are shaped by various so... more
This report provides an update on the key facets of HIV treatment access, including the latest HIV treatment guidelines from World ... Organization (WHO), an overview on pricing for first-line, second-line, and salvage regimens, and a summary of the opportunities for – and threats to – expanding access to affordable antiretroviral therapy (ART). The report is supplemented by 11 drug profiles that contain more detailed information on pricing trends and patent barriers for key antiretroviral drugs and fixed-dose combinations. Also included is an annex of conditions that define eligibility for reduced prices from 15 pharmaceutical companies. more
The report underscores that sexual and reproductive health and rights are often the first to be sacrificed during epidemics and that ... gains of the past decade must be protected. The report also makes it clear that scarce resources must be focused on the most marginalized women and girls, including sex workers, gender diverse people, women in prison and migrants and others without proof of employment or residence. more

Responses of the Catholic Church to HIV and AIDS in Africa: Lessons learned

Fleischer, K., et al. German Bishops' Conference Research Group on International Church Affairs (2015) CC
An international field study by African and German theologicans and health workers.
7 Febr. 2021 As COVID-19 continues to wreak havoc in countries – decimating people’s livelihoods, and leaving health systems struggling to provide healthcare and vaccines for the entire populat... more

Health and Socio-Economic Impacts of Physical Distancing for Covid-19 in Africa

Barasa, E.; et al. KEMRI-Wellcome Trust Research Programme and African Academy of Sciences (2020) CC
Physical distancing measures are important to reduce COVID-19 transmission. However, when stringently applied, they can result in negative health and socio-economic impacts. This report draws on a rapid review ... available literature, case studies from across Africa and expert knowledge to make recommendations on adapting classic physical distancing measures to the contextual realities in Africa and on mitigating potential negative impacts. more