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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

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

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

Intention to action series: Regional reflections. Analysis from informal regional consultations with people living with noncommunicable diseases and mental health conditions 2023 WHO

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

This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit... more

Project/programme planning - Guidance manual

International Federation of Red Cross and Red Crescent Societies IFRC (2024) CC

The aim of this guidance manual is to introduce the user to project/programme plan- ning in a Red Cross Red Crescent environment. It describes the different stages of the planning phase of the “project/programme cycle” within the context of Results-Based Management (RBM). It also gives an overvi... more

Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 4: developing an implementation plan

World Health Organization (WHO) World Health Organization (WHO) (2022) C_WHO

World Health Organization. (‎2022)‎. Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 4: developing an implementation plan.

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

Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes

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

The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub... 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

The ISN framework for developing dialysis programs in low-resource settings

International Society of Nephrology (2021) CC2

Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable diseases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over... more

Building health system resilience to public health challenges: guidance for implementation in countries

World Health Organization WHO (2024) C_WHO

Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co... more

Medical device donations: considerations for solicitation and provision. Second edition

World Health Organization WHO (2024) CC

Medical devices are used for the prevention, diagnosis and treatment of illness and diseases and for rehabilitation. WHO developed guidance on medical device donation in 2011, which has been now reviewed, with new evidence, new references on considerations for medical device solicitation and provisi... more

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

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

UNAIDS Terminology Guidelines

UNAIDS (2024) CC

Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of ind... more

Addressing gender inequalities in national action plans on antimicrobial resistance

World Health Organisation (WHO) (2024) C_WHO

National action plans on antimicrobial resistance (AMR) often overlook the critical intersection of gender, despite evidence that exposure and susceptibility to infection, health-seeking behaviours, as well as antimicrobial prescribing and use patterns are all influenced by gender.

Prevention and response to sexual misconduct: WHO stakeholder review conference 2023

World Health Organisation (WHO) (2024) C_WHO

At the end of 2023, WHO convened our first-ever annual WHO Stakeholder Review Conference for Prevention and Response to Sexual Misconduct. Aimed at joint learning and frank discussion on challenges faced in the achieving zero tolerance for all forms of sexual misconduct by aid workers, the Conferenc... more

Implementation toolkit for accessible telehealth services

World Health Organisation (WHO) (2024) C_WHO

The Implementation toolkit for accessible telehealth services provides practical guidance to support governments, industry partners, health service providers and civil society groups in the use and implementation of the WHO-ITU Global standard for accessibility of telehealth services. The toolkit is... more

Taking Stock: Sexual and Reproductive Health and Rights in Climate Commitments - an East and Southern Africa Review

UNFPA (2024) CC

Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential health services, including those that addres... more

Refugee and Migrant Health System Review: Challenges and Opportunities for Long-term Health system Strengthening in Uganda

Government of Uganda; World Health Organization WHO (2024) C_WHO

Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re... more