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Integritas 4.3 (Fall 2014), pp. 1-30.
doi: 10.6017/integritas.v4i3p1
Directions in Development
Human Development
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 ...
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.
Este livro em formato prático é dirigido a médicos, enfermeiros e demais profissionais de saúde responsáveis pelo cuidado de crianças no primeiro nível de referência em países em desenvolvimento. Apresenta diretrizes clínicas atualizadas q...
Antimicrobial resistance (AMR) is a global threat that requires urgent collaborative action within and among countries. AMR makes standard treatments ineffective and facilitates the spread of antimicrobial resistant infections rendering communities ...
Child friendly spaces (CFS) have become a widely
used approach to protect and provide psychosocial
support to children in emergencies. However,
little evidence documents their outcomes and
impacts. There is widespread commitment among
humanitar...
Global tuberculosis report 2022
recommended
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Male circumcision reduces a man’s risk of heterosexual acquisition of HIV by about 60%. This guideline provides an evidence-based recommendation on the use of adult male circumcision devices for HIV prevention in public health programmes in high H...
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Este livro de bolso destina-se a ser usado por médicos, enfermeiras e outros trabalhadores de saúde experientes que sejam responsáveis pela prestação de cuidados de saúde a crianças nos país...
28 May 2021
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This special issue on Newborn Health in Global Health Action is being launched to share the experience of how to scale up a cost-effective package of newborn care that involves families, community health workers and health facilities. The results of...
The Government of Botswana’s SRH Policy Guidelines and Service Standards document provides the framework for developing a responsive strategy and an implementation plan for SRHR and HIV&AIDS Linkages and Integration. The global call on governments...
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Lymphatic filariasis is a vector-borne neglected tropical disease that causes damage of the lymphatic system and can lead to lymphoedema (elephantiasis) and hydrocele in infected individuals. The global baseline estimate of persons affected by lymph...
New criteria for classifying and diagnosing hyperglycaemia first detected during pregnancy have been accepted by a group of experts convened by WHO. These new criteria are an update of recommendations published by WHO in 1999
To its credit, Chile has implemented a highly successful vaccine program and taken a number of other important public health measures to improve the well-being of its inhabitants. Nevertheless, t...
