The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the
provision of basic health services in rural and urban communities with the participation of people who live there.
Historically, Community Health has significantly contributed to im...provements in Malawi’s health outcomes in particular
attainment of MDG4. However, the community health system faces resource constraints and inconsistencies around quality
of service – which negatively affect health outcomes.
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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.
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Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Met...hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
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Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and
reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist
yet sadly approximately only 3.2 million children with SAM have access to treatme...nt each year2. Thus, there
is a need to scale up interventions to improve coverage and access across high burden countries. While efforts
are currently underway to expand services in many countries, obstacles remain.
One critical barrier to expanding SAM treatment services is the acceptance, accessibility and utilisation of
ready-to-use therapeutic food (RUTF). In some countries and contexts, RUTF is still not fully accepted by
community members; while other countries face problems with procurement, storage and supply chain
management which impact on availability and use3. Reports from Ghana and Zambia highlighted that stock-
outs and logistical challenges are often noted as key contributors to high default rates in outpatient treatment
centres4.
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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 ...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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The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca...ncer care services through regional collaboration and integrating NCD services in when responding to emergencies.
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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...ies, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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El presente informe incluye análisis de consultas informales en cinco de las regiones de la OMS: la Región de África, la Región de las Américas (donde se realizaron consultas separadas para el Caribe y América del Norte, y para América Latina), la Región de Asia Sudoriental, la Región de Eu...ropa y la Región del Mediterráneo Oriental, junto con tres foros en la Región del Pacífico Occidental. Se analizan las similitudes generales, los matices regionales y las prioridades planteadas en las seis regiones de la OMS para la participación significativa de las personas con experiencias vividas.
El presente informe es la segunda publicación de la serie «De la intención a la acción», un conjunto de recursos destinados a mejorar la limitada base de evidencia sobre el impacto de la participación significativa y abordar la falta de enfoques normalizados sobre cómo hacer operativa esta participación. La serie «De la intención a la acción» pretende llevar esto a cabo proporcionando una plataforma desde la que las personas con experiencias vividas, y los defensores de organizaciones e instituciones, puedan compartir soluciones, retos y prácticas prometedoras relacionadas con esta agenda transversal. La serie «De la intención a la acción» también tiene como objetivo proporcionar poderosas historias, inspiración y evidencia para la 4.ª Reunión de Alto Nivel de las Naciones Unidas sobre las ENT que se celebrará en 2025 y la consecución de los Objetivos de Desarrollo Sostenible (ODS) de las Naciones Unidas para 2030.
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The Global Status Report on Noncommunicable Diseases (NCDs) 2014 by the World Health Organization outlines the global impact of NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are responsible for a significant portion of global mortality, particular...ly in low- and middle-income countries.
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The Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 by the World Health Organization (WHO) outlines a comprehensive strategy to address the global rise in noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, chronic respiratory diseases,... and diabetes.
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This toolkit is a "how to" guide for developing, implementing and evaluating a multisectoral action plan for prevention and control of NCDs. It is targeted at policy-makers, planners and programme managers, and is intended to help countries, provinces and cities meet the requirements for achieving g...lobal and national NCD targets and the Sustainable Development Goals. The toolkit takes the user through a series of actions related to the development of a multisectoral action plan ("MSAP development actions"), and provides forms and a template framework for users to complete as they undertake these actions. Developing a multisectoral action plan involves establishing health needs and engaging relevant stakeholders before determining the actions to take, identifying and prioritizing interventions, deciding on ways to address NCDs while establishing support and resources for prevention and control, and evaluating progress in implementing the plan.
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To maintain a structured and well-organized implementation plan it is important to have a lead agency or sector. The ministry of health or a similar authority in government will be critical in facilitating development and implementation of the multisectoral action plan.
One of the first steps in developing a multisectoral action plan (MSAP) is to use a situation analysis to provide a comprehensive assessment of the health needs, prevailing risks and the context of the area to which the plan will apply. This will help countries, regions, provinces or cities intendi...ng to create a multisectoral action plan to align with the global commitments on targeting the four major NCDs: cardiovascular disease, diabetes, cancer and chronic respiratory diseases.
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This toolkit is a "how to" guide for developing, implementing and evaluating a multisectoral action plan for prevention and control of NCDs. It is targeted at policy-makers, planners and programme managers, and is intended to help countries, provinces and cities meet the requirements for achieving g...lobal and national NCD targets and the Sustainable Development Goals. The toolkit takes the user through a series of actions related to the development of a multisectoral action plan ("MSAP development actions"), and provides forms and a template framework for users to complete as they undertake these actions. Developing a multisectoral action plan involves establishing health needs and engaging relevant stakeholders before determining the actions to take, identifying and prioritizing interventions, deciding on ways to address NCDs while establishing support and resources for prevention and control, and evaluating progress in implementing the plan.
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El documento, "Progreso en la prevención y el control de las enfermedades no transmisibles" (ENT), informa sobre los esfuerzos globales para reducir el impacto de las ENT, como las enfermedades cardíacas, el cáncer, la diabetes y las enfermedades respiratorias crónicas, siguiendo los compromisos... asumidos en reuniones de alto nivel de las Naciones Unidas. Destaca el progreso insuficiente para alcanzar las metas establecidas en el Objetivo de Desarrollo Sostenible 3.4, que busca reducir en un tercio la mortalidad prematura por ENT para 2030. Los desafíos clave incluyen la falta de financiamiento, la implementación limitada de intervenciones efectivas y barreras políticas y económicas, especialmente en países de bajos ingresos. El informe hace un llamado para fortalecer la cooperación internacional, reformar políticas y adoptar enfoques innovadores para cumplir con las metas de salud global.
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The "Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases: Report of the 2021 Global Survey" by WHO examines the global state of readiness and infrastructure for managing noncommunicable diseases (NCDs) across countries. Based on the 2021 survey, it analyzes nationa...l capabilities in public health infrastructure, policies, health systems, and the impact of the COVID-19 pandemic on NCD-related resources. The report highlights gaps and strengths in NCD prevention, treatment, and health policy integration, offering insights for improving NCD care worldwide. It emphasizes the need for multisectoral collaboration and targeted actions to meet global health goals.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium ...term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally,... research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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Public health emergencies, including pandemics, highlight the need for health systems and services that are prepared, resilient and ready to respond to health security threats. Endorsed by Member States in 2023, the Asia Pacific Health Security Action Framework (APHSAF) is designed to engage m...ultisectoral actors in health security, and to reflect the complex nature of current and future public health emergencies. The Framework presents six interconnected, multisectoral domains of work that together form a comprehensive, multi-hazard health security system — emphasizing the One Health approach. The Framework also supports progress towards the Sustainable Development Goals and universal health coverage while meeting the responsibilities and obligations of the International Health Regulations (2005).
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The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of ...the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
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