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 mu...st 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
The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countries, the causes of COPD are often multifactorial, inv...olving environmental tobacco smoke, biomass fuel smoke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa.
more
Pocket guide to show the positive impact that physical activity can have on your own mental wellbeing, including some tips and suggestions to help you get started.
There are many reasons why physical activity is good for your body having a healthy ...heart and improving your joints and bones are just two, but did you know that physical activity is also beneficial for your mental health and wellbeing
more
The transformation of the humanitarian landscape has already made a significant impact on the operational security of INGOs and other humanitarian actors. This report serves to inform strategic policy priorities and approaches to security planning a...nd coordination, and addresses three main questions: 1. What are the emerging trends, developments and drivers of change that are likely to affect or change security issues and considerations in the humanitarian environment of the future? 2. How will the humanitarian sector need to adapt in order to continue to deliver programmes within this changing operational context? 3. How prepared are organisations for this future, and what might they need to do differently in order to be prepared?
more
Recent systematic reviews and meta-analysis of the impact of chemical-based mollusciciding (King et al., 2015, Sokolow et al., 2016) have concluded that regular mollusciciding is likely to contribute significantly towards elimination of schistosomia...sis in high-risk areas. The WHO roadmap’s new focus on “transmission control, wherever possible” (WHO, 2012a) reinforces the need to promote intermediate-host snail control to prevent schistosomiasis transmission.
This operational manual is intended to facilitate the reintroduction of practices and protocols for use of molluscicides in the field in schistosomiasis control programmes. It is complemented by guidelines on the laboratory and field testing of the efficacy of molluscicides for schistosomiasis control (WHO, 2017 [in preparation]).
more
The results of a WHO survey conducted to assess the impact of the COVID-19 pandemic on up to 25 essential health services in countries show disruptions of essential health services in nearly all countries, and more so in lower-income than higher-inc...ome countries. The great majority of service disruptions were partial, which was defined as a change of 5–50% in service provision or use.
more
Preliminary overview of refugees and migrants self-reported impact of COVID-19
The study surveyed over 30,000 refugees and migrants living in 170 countries. Many of the respondents had fled war or dire economic conditions in their home country only... to be faced with the additional challenges posed by COVID-19. Travel restrictions including border closures, suspension of resettlement travel, and last-minute deportation left many stranded or forced to stay in cramped, makeshift shelters or detention centers. Amid these uncertain, precarious conditions, many migrants described either a lack of access to health services or a fear of seeking them out — even if they were experiencing COVID-19 symptoms.
more
The Demographic Dividend study on Rwanda assessed the socio-economic and human development potential of our country in the short, medium and long-term period using a comprehensive approach. It generated relevant policy and programme information to g...uide a well-informed polciy required to propel Rwanda towards achieving its aspirations of being high middle income country by 2035 and high income country by 2050.
The primary objectives of this study were to assess Rwanda’s prospects for harnessing the demographic dividend and demonstrate priority policy and programme options that the country should adopt in order to optimise its chances of earning a maximum demographic dividend in the context of its youthful population and medium, long-term socio-economic development aspirations.
more
Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find th...at the incentives had a large and significant effect on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
more
This analytical report reviews and discusses the potential role and influence of political commitment in implementing endorsements and conducting policy in the field of tuberculosis (TB) prevention and care. It promotes discussion by comparing and a...nalysing the extent to which selected international commitments, set out in declarations and other committal documents between 2000 and 2018, may have translated into sustainable action. This reflection is relevant and timely, as the United Nations high-level meeting (UNHLM) on TB recently took place, offering countries the opportunity to take stock of progress made, refocus efforts, and step up global commitments to achieve the United Nations Sustainable Development Goal of eliminating TB by 2030
more
While the full extent of Cyclone Ida’s impact is still being assessed, early reports indicate significant damage to infrastructure and livelihoods, with an estimated 3,000km2 of land submerged. Preliminary government reports as of 24 March indicat...e that more than 58,600 houses have been damaged, including 36,747 totally destroyed, 19,733 partially destroyed and 2,184 flooded. More than 500,000 hectares of crops have been damaged, which is expected to significantly increase food insecurity given that the flooding has coincided with the annual harvest season. More than 3,100 schools have been damaged, along with at least 45 health centres.
Nearly 110,000 people remained displaced in more than 130 accommodation centres – mostly schools and other public buildings – in Sofala (90), Manica (26), Zambezia (10) and Tete (4), where humanitarian needs are acute and both the risk of communicable disease outbreaks and protection risks – particularly for women and girls – are high
more
Guidelines
June 2017
HIV strategic information for impact
How has the DRC Ebola outbreak impacted Sexual and Reproductive Health in North-Kivu?
Recommendations (more specifics found in the assessment):
1. Sexual and reproductive health needs and services are to be embedded in the EVD response from the ou...tset.
2. Reduce delays at every stage of the patient journey, particularly for women experiencing obstetric complications, including complications from abortion.
3. Support individuals and communities to mitigate SRH risks posed during and after EVD epidemic:
4. Formulate SRH guidelines for the EVD context involving experts in all relevant fields.
more
Community health nurses have the potential to make significant contributions to meet the health care needs of various population groups in a variety of community settings. In order to assess the extent to which CHNs are achieving this ...ttribute-to-highlight medbox">potential, WHO conducted a study between 2010 and 2014 that examined the status of community health nursing in 22 countries, 13 of which were experiencing a critical shortage of health care workers. The study revealed that the countries surveyed had the basic and operational framework for optimizing CHN in their health systems as evidenced by the availability of PHC structures to guide interventions. However, challenges were identified related to the education, practice and management of CHNs in these countries. The major challenges identified were: Limited availability of career opportunities; poor worker retention; low recognition for CHNs; inadequate and unsupportive working conditions and environments; absence of educational standards; varying educational entry-level requirements for CHN programmes; and a lack of consensus on the scope of practice for CHNs.
more
Herd immunity by mass vaccination offers the potential to substantially limit the continuing spread of COVID-19, but high levels of vaccine hesitancy threaten this goal. In a cross-country analysis of vaccine hesitant respondents across Latin Americ...a in January 2021, we experimentally tested how five features of mass vaccination campaigns—the vaccine’s producer, efficacy, endorser, distributor, and current population uptake rate—shifted willingness to take a COVID-19 vaccine. We find that citizens preferred Western-produced vaccines, but were highly influenced by factual information about vaccine efficacy. Vaccine hesitant individuals were more responsive to vaccine messengers with medical expertise than political, religious, or media elite endorsements. Citizen trust in foreign governments, domestic leaders, and state institutions moderated the effects of the campaign features on vaccine acceptance. These findings can help inform the design of unfolding mass inoculation campaigns.
more
The roadmap highlights and advocates for the existing and potential key role of national public health institutes (NPHIs) in climate adaptation and mitigation, and how they contribute to climate policies, research and action.
This document provides interim guidance for effective risk communication around Zika virus transmission and potential complications. A causal relationship between Zika virus infection and these potential...span> complications has not yet been proven. In this uncertainty, effective communication strategies should be implemented to enable people to take the best informed decisions about protecting themselves, their families and communities. This interim guidance is intended to be used by risk and health communication managers, staff and volunteers at global, regional or country level; communications professionals; anthropologists; sociologists; healthcare providers;hospital administrators; community leaders; programme managers;
and policymakers.
more
Recently, Sri Lanka has been impacted by multiple natural disasters. Sri Lanka experienced a landslide in October 2014, and flooding in December 2014.8 Sri Lanka withstood the worst drought conditions witnessed in four decades in 2016; the extreme d...rought conditions extended into 2017 and produced substantial economic and social effects. The drought was responsible for an increase in national poverty levels, due to reduced cultivation income, especially for rural farmers. ... In May 2017, Sri Lanka experienced continuous rains causing flash floods and extreme devastation. However, despite natural disasters and challenges posed by a complex political environment, Sri Lanka’s financial performance remained largely satisfactory in the first half of 2017.
more
Zambia has recognised the Public Health threat of antimicrobial resistance and its impact on morbidity and mortality, as well as the subsequent economic consequences. The country has recorded microorganisms which have developed resistance to antimic...robial drugs. Notable among these are; Multidrug Resistant Mycobacterium Tuberculosis (MDR), Human Immunodeficiency virus resistant to antiretroviral drugs, Plasmodium resistance to antimalarial drugs, and fungal species showing indications of resistance to antifungal drugs. Emergence of “Superbugs” such as Methicillin Resistant Staphylococcus aureus (MRSA), Extended Spectrum beta-lactam (ESBL) producing Klebsiella pneumoniae and Vancomycin Resistant Enterococci (VRE) have also been reported.
more
In this report, potential reasons for this apparent
contradiction between cherished human values
and observed social actions are explored with a
view to better formulating concrete steps that
governments and other stakeholders can take to
resha...pe social attitudes and public policy.
more