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
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health facilities, but must pay elsewhere. Before the government implements a payment policy in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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This document is written for medical doctors, clinical officers, medical assistants, nurses, midwives, health surveillance assistants (HSAs), and medical records clerks who are working in public and private sector
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health facilities in Malawi. It is designed to be a practical guide for implementation of integrated HIV services.
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The Government of Malawi, in fulfilling its primary role of protecting the lives of its vulnerab
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le citizens during disasters and reducing their exposure to risk through preparedness, led the development of a National Coronavirus Disease (COVID-19) Preparedness and Response Plan.
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These toolkits were produced and used as part of the Moyo ndi Mpbamba project in Malawi to guide the community mobilization process in target districts.
The study sought to understand the factors that facilitate women to adhere to treatment and return to health facilities for routine care from their own perspective. The researchers focused on Malawi
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, Uganda and Zambia, early adopters of the global guidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, trea
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tment, 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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Malawi Integrated Guidelines and Standard Operating Procedures for Providing HIV Services. 3rd edition 2016
This document defines the framework for Malawi’s National HIV Programs. Considering public health benefits and risks, as well as funding and resource implications, deviations from these guidelines
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are not supported by the Ministry of Health.
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This external performance evaluation of the Malawi Girls’ Empowerment through Education and Health Activity (ASPIRE), conducted 2.5 years after A
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SPIRE began, establishes the activity’s progress against its objectives, proposes adaptations for the final year, and captures lessons for application in future girls’ empowerment, health, and education programming in Malawi.
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PLoS ONE 11(1): e0144662. doi:10.1371/journal.pone.0144662
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) emphasi
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ses the role of preexposure prophylaxis (PrEP) in reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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