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Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

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. more

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Strengthening the health systems response to COVID-19: technical guidance #6: preventing and managing the COVID-19

World Health Organization (Europe) (2020) C_WHO

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Defining Disability - A Guideline for Medical Doctors and Primary Health Care Workforce

Prof. AHM E. Hussain; Dr. N. Mohammad; Dr. Md. R. Karim; et al. Government of the People's Republic of Bangladesh DGHS Directorate General of Health Services Ministry of Health and Family Welfare ; NCDC; drra; et al. (2019) C2

January 2019 Non Communicable Disease Control Programme Directorate General of Health Services Health Services Division, Ministry of Health & Family Welfare

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Educational support for orphans and vulnerable children in primary schools: Challenges and interventions

T. Mwoma; J. Pillay Issues in Educational Research (2016) C2

Issues in Educational Research, 26(1), 2016

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The use of low-cost Android tablets to train community health workers in Mukono, Uganda, in the recognition, treatment and prevention of pneumonia in children under five: a pilot randomised controlled

J.O’Donovan, K. Kabali, C. Taylor, et al. (2018) CC

Human Resources for Health201816:49; https://doi.org/10.1186/s12960-018-0315-7

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National HIV viral load testing guidelines to support HIV and AIDS prevention, care and treatment
recommended

Ministry of Health and Social Welfare, National AIDS Control Programme, Tanzania (2015) C1

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Recommended package of interventions for HIV, viral hepatis and STI prevention, diagnosis, treatment and care for people who inject drugs: policy brief

World Health Organisation (WHO) (2023) C_WHO

HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination... more

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Integrated Communication Strategy for the Introduction of Oral Cholera Vaccine in Cholera Prevention and Control Programmes

UNICEF (2014)

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The development of harmonized minimum standards for guidance on HIV testing and counselling and prevention of mother-to-child transmission on HIV

SAHARA SADC, African Development Bank (2009) C2

HTC COUNTRY REPORT | LESOTHO

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Overview of WHO recommendations on HIV and sexually transmitted infection testing, prevention, treatment, care and service delivery

World Health Organization WHO (2025) C_WHO

This document highlights the latest WHO recommendations designed to optimize health outcomes, streamline delivery and address persistent barriers to prevention and care. It especially focuses on people often left behind in service delivery, including adolescents and young people, key populations and... more

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National Guidelines on Promoting Access of Young People to Adolescent- and Youth-Friendly Services in Primary Health Care Facilities in Nigeria

Federal Ministry of Health, Nigeria (2014) C1

External Link

Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study

Adelekan, B.; E. Goldson, Z. Abubakar et al. Repoductive Health Journal (2021) CC

RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur... more

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Introducing and scaling up testing for human papillomavirus as part of a comprehensive programme for prevention and control of cervical cancer

World Health Organization WHO (2020) C_WHO

This guidance is intended to be used by programme managers following the decision to introduce human papillomavirus (HPV) virological testing as a screening assay in their national cervical cancer prevention and control programme. The guidance includes a step-by-step process to be followed after the... more

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Etude de cas sur le fonctionnement des relais communautaires dans le cadre de la prévention de la sous-nutrition
recommended

ACF International, SIDA (2020) C2

Accessed on 28.01.2020 Dans le cadre de la mise en œuvre d’approches spécifiques à la nutrition telles que les pratiques ANJE pour lutter contre la sous-nutrition, le renforcement de la santé communautaire et du rôle des relais communautaire est essentiel. Si de nombreux projets ont été ... more

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Technical brief: improving surgical male circumcision practice - urethral fistula: diagnosis, first management and prevention

World Health Organization WHO (2021) C_WHO

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National Policy on HIV, STIs and TB for Learners, Educators, School Support Staff and Officials in all Primary and Secondary Schools in the basic Education Sector

Department of Basic Education; NDP; Read to Lead (A reading Nation is a leading Nation) (2019) C2

Accessed: 13.10.2019

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Enhancing access to services for migrants in the context of COVID-19 preparedness, prevention, and response and beyond

Working Group on Access to Services of the UN Network on Migration, et al. (2020) CC

The United Nations Network on Migration is committed to supporting all partners in pursuit of the implementation of the Global Compact for Safe, Orderly and Regular Migration, recognizing that this cooperative framework provides an invaluable tool for ensuring inclusive, collective responses to COVI... more

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Global Report on Diabetes World Health Organization 2016 1. Diabetes Mellitus – epidemiology. 2. Diabetes Mellitus – prevention and control. 3. Diabetes, Gestational. 4. Chronic Disease.

World Health Organization WHO (2016) C_WHO

The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease, the associated risk factors, and the increasing burden on healthcare systems, particularly in low- a... more

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Study on Public Knowledge, Attitudes, and Practices Relating to Ebola Virus Disease (EVD) Prevention and Medical Care in Sierra Leone
recommended

Catholic Relief Services CRS; Focus 1000; UNICEF (2014) C1

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WHO technical guidance and specifications of medical devices for screening and treatment of precancerous lesions in the prevention of cervical cancer

World Health Organization WHO (2020) C_WHO

Globally, 311,000 women die of cervical cancer every year, 85 percent of them in resource limited regions of the world. To address this grave threat to women, the WHO made a call to action in 2018, resulting in accelerated plans to improve cervical cancer control under the elimination threshold w... more

National HIV viral load testing guidelines to support HIV and AIDS prevention, care and treatment recommended

Etude de cas sur le fonctionnement des relais communautaires dans le cadre de la prévention de la sous-nutrition recommended

Study on Public Knowledge, Attitudes, and Practices Relating to Ebola Virus Disease (EVD) Prevention and Medical Care in Sierra Leone recommended

National HIV viral load testing guidelines to support HIV and AIDS prevention, care and treatment
recommended

Etude de cas sur le fonctionnement des relais communautaires dans le cadre de la prévention de la sous-nutrition
recommended

Study on Public Knowledge, Attitudes, and Practices Relating to Ebola Virus Disease (EVD) Prevention and Medical Care in Sierra Leone
recommended