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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The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care services and systems to deliver integrated care in community settings and support the development of ICOPE implementation action plans. There are 19 actions needed to implement ICOP...E on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements
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This handbook is an adaptation from the WHO Clinical Handbook Health care for women subjected to intimate partner violence or sexual violence developed by the World Health Organization (WHO), UN Women and United Nations Population Fund. The handbook draws on the work from professionals who are dedic...ated to preventing and responding to Gender Based Violence.
The Handbook guides health care service providers to provide comprehensive services to survivors of intimate partner violence and/or sexual violence. It also guides health professionals with respect to relevant stakeholders for referral purposes. The purpose is to ensure that relevant authorities are informed timeously in order act and ensure that those affected by violence receive speedy service as required.
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WHO has been alerted to concerns expressed related to the wording on episiotomy in specific situations. We have temporarily removed the publication from the website while we are doing a review of the evidence with in-house and external experts. We will make the publication available on the website o...nce the review is completed and any needed revisions are made. Please check the website!!!
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Consolidated Guidelines
Geneva, 2016
The End TB Strategy
The END TB Strategy
Интеграция совместного оказания услуг в связи с ТБ и ВИЧ во всеобъемлющий пакет помощи для потребителей инъекционных наркотиков
Revided Version
September 2013
January 2019
Non Communicable Disease Control Programme Directorate General of Health Services Health Services Division, Ministry of Health & Family Welfare
A cross-sectional descriptive study design covering all states and regions was undertaken to:
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of health facilities,
2) To assess quality of RH services with emphasis on family ...planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities.
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