Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary
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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 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.
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Countries reported disruptions in all health-care settings. In more than half of countries surveyed, many people are still unable to access care at the primary care and community care levels. Significant disruptions have also been reported in emerg
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ency care, particularly concerning given the impact on people with urgent health needs. Thirty-six per cent of countries reported disruptions to ambulance services; 32% to 24-hour emergency room services; and 23% to emergency surgeries.
Elective surgeries have also been disrupted in 59% of countries, which can have accumulating consequences on health and well-being as the pandemic continues. Disruptions to rehabilitative care and palliative care were also reported in around half of the countries surveyed.
Major barriers to health service recovery include pre-existing health systems issues which have been exacerbated by the pandemic as well as decreased demand for care.
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In 2015, 5.9 million children under age five died (1). The major causes of child deaths globally are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhoea, injuries and malaria (2). Most of these diseases and conditions are at least partially cau
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sed by the environment. It was estimated in 2012 that 26% of childhood deaths and 25% of the total disease burden in children under five could be prevented through the reduction of environmental risks such as air pollution, unsafe water, sanitation and inadequate hygiene or chemicals.
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The Millennium Development Goals (MDGs) showed
that global commitment and collective action
could significantly reduce the disease burdens of
three deadly communicable diseases: HIV/AIDS,
tuberculosis (TB) and malaria. The MDGs helped
focus efforts on
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these three deadly diseases
and leveraged disease-specific programmes and
financing, thus achieving significant progress.
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The report shows that older people are not getting the healthcare treatments they desperately need. The COVID-19 response has disrupted services for non-communicable diseases such as cancer and diabetes, communicable diseases such as malaria, and much-needed services for mental
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health. Combined with a loss of income, many older people are unable to get the medicines they need.
A Summary is available in Russian and Arabic
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International Journal of Mental Health Systems2011,5:17http://www.ijmhs.com/content/5/1/17
World Health Organization Department of Reproductive Health and Research
Brocher Foundation, Hermance, Geneva, Switzerland, 27–29 April 2016
Background: The impacts of air pollutants on health range from short-term health impairments to hospital admissions
and deaths. Climate change is
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leading to an increase in air pollution.
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Guidelines
June 2017
HIV strategic information for impact
BackgroundClimate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the enti
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re scientific community. Rising temperatures, heat waves, floods, tornadoes, hurricanes, droughts, fires, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental.
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This global progress report attempts to lay the groundwork for the kind of accelerated action needed. Section 1 presents key data, trends and developments in women’s, children’s and adolescents’ health and well-being. That is followed in Secti
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on 2 by a deeper dive into the impact of the COVID-19 pandemic, which has created and contributed to many threats and challenges to progress for women, children and adolescents. In Section 3, the report concludes with recommendations for accelerating progress towards the achievement of the 2030 Agenda even in such challenging times, with an emphasis on partnership
and clear-eyed recognition of the consequences of failing to do better.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In
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Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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The World Health Organization (WHO) has identified mental health as an integral component of the COVID-19 response. Its rapid assessment of service delivery for mental, neurological and substance us
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e (MNS) disorders during the COVID-19 pandemic, on which this report is based, is the first attempt to measure the impact of the pandemic on such services at a global level. The data were collected through a web-based survey completed by mental health focal points at ministries of health between June and August 2020. The questionnaire covered the existence and funding of mental health and psychosocial support (MHPSS) plans, the presence and composition of MHPSS coordination platforms, the degree of continuation and causes of disruption of different MNS services, the approaches used to overcome these disruptions, and surveillance mechanisms and research on MNS data.
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The purpose of the toolkit is to bring together existing learning and guidance as a starting point for stakeholders to begin SRH preparedness work. Within the SRH sector the field of preparedness is relatively new and growing. More collective effort is required to further evaluate the
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impact of preparedness efforts and push the field forward. This effort is a first attempt at a draft guidance for SRH preparedness, and is intended for field testing. The toolkit recognizes the longstanding work of the field of emergency and disaster risk management, and endeavors to bridge that work with the human rights-oriented and peoplecentered field of sexual and reproductive health.
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The health and socioeconomic crisis triggered by the COVID-19 pandemic has hit the countries of Latin America hard and laid bare the profound inequities about which numerous international, regional and national reports have sounded warnings in recen
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t decades. In this context, the historical political and economic exclusion and marginalization of the more than 800 indigenous peoples in the region has been accentuated as a result of insufficient State responses to the crisis, which have not adequately considered the collective rights of these peoples and have had little cultural relevance.
This document provides an overview of the situation of indigenous peoples in the region in the face of the COVID-19 pandemic. It analyses both the State’s and indigenous peoples’ own responses to the crisis, as well as offering a set of recommendations to rectify the neglect of these peoples in the management of the pandemic, centring on their collective rights.
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The magnitude and complexity of these mental health conditions caused by prolonged and extensive trauma requires a diagnosis fitting the unique context of the Syrian conflict. Over half a million people have been killed since the beginning of the co
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nflict in 2011, and more than 6.4 million are internally displaced with over 5 million living as refugees. SAMS documents the multi-dimensional nature of mental health disorders afflicting Syrians, including accounts of refugee experiences from Eastern Ghouta, Idlib, and beyond. This qualitative report seeks to raise awareness about increasing mental health needs, while sharing personal stories of those who have been affected by the trauma of the conflict.
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Nepal has made substantial progress in reducing under-five mortality and is on track to achieve Millennium Development Goal 4, but advances in neonatal health are less encouraging. The objectives of
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this study were to assess relative and absolute inequalities in neonatal mortality over time, and to review experience with major programs to promote neonatal health.
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Environment International Volume 86, January 2016, Pages 14-23
Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing
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health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects — the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial–temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change.
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.
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In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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