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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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2 million African community health workers - Harnessing the demographic dividend, ending AIDS and ensuring sustainable health for all in Africa

UNAIDS (2017) CC

This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and ... more

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The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

Kigume, R.; Maluka, S. (2021) CC2

Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study... more

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Community health worker perspectives on a new primary health care initiative in the Eastern Cape of South Africa

Austin-Evelyn K, Rabkin M, Macheka T, Mutiti A, Mwansa-Kambafwile J, Dlamini T, et al. PLoS ONE (2017) CC

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Nepal: Vulnerable Community Development Plan

Ministry of Health, Government of Nepal (2016) C1

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Community consultation on the role of peer support in the Retention of women, adolescents and children in HIV care and treatment

World Health Organization ( WHO Regional Office for Africa), ICW, Unicef, (2017) C_WHO

16-17 November 2017, Hotel Djeugua, Yaoundé, Cameroon Meeting Report December 2017

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A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno Distr

Wroe, E.B.; Nhlema, B.; Dunbar, E.L. et al. BMJ Global Health (2021) CC

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan... more

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Policy Brief No. 5 : Practices in Community-Based Health Initiatives

Aga Khan Health Services, Kenya (2015)

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Community-Based Disaster Risk Reduction (CBDRR) Manual in Lao PDR

(2016) C1

The CBDRR Manual is a practical ‘how-to’ guide on community-based disaster risk reduction for government and non-government agencies in Lao PDR. It is a commonly agreed document to be referred to by agencies working on CBDRR in Lao PDR. It provides guidance and support for systematic implementat... more

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Impact of community-led and community-based HIV service delivery beyond HIV: case studies from eastern and southern Africa

UNAIDS (2025) C1

The objectives of the research presented in this report were to identify case studies of community-led HIV-related health and social inclusion service delivery organizations in eastern and southern Africa; describe the typologies of the services provided; and identify evidence of their service deliv... more

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The legal and regulatory framework for community pharmacies in the WHO European Region

World Health Organization WHO, Regional Office of Europe (2019) C_WHO

Community pharmacists are the health professionals most accessible to the public and are a cornerstone of primary health care. The role of community pharmacists is expanding globally. This report provides an overview of existing components and provisions of the legal and regulatory framework for com... more

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Manual on Community-Based Disaster Risk Reduction

Myanmar Red Cross Society (2013) C1

Overview:
- Part A is an introductory part which will give you background information about CBDRR in Myanmar. It has a small section about the importance of CBDRR in Myanmar, the stakeholders of CBDRR in Myanmar, as well as an overview about the challenges that are faced when implementing CBDRR... more

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Training and Evaluation of Community Health Workers (CHWs): Towards Improving Maternal and Newborn Survival in an Urban Setting in KwaZulu-Natal, South Africa

Thoko Ndaba1, Myra Taylor, Musawenkosi Mabaso The Open Public Health Journal (2019) C1

CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at home immediately after discharge from health care c... more

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Context Analysis: Close-to-Community Health Care Service Providers in Bangladesh

M. SHOWKAT GANI et al. Reach Out; European Union (2014) C1

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A Guide for Training Community Health Workers/Volunteers to Provide Maternal and Newborn Health Messages

USAIDBASICS and POPPHI (2009)

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Community Assessment For Public Health Emergency Response (Casper) Toolkit; third edition 3.2
recommended

Centers for Disease Control and Prevention CDC (2019) CC

2nd edition

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Community-Based Rehabilitation as we have experienced it…

World Health Organization (WHO) (2002) C_WHO

…voices of persons with disabilities - Part 1

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Evaluating the impact of community health worker integration into prevention of mother-to-child transmission of HIV services in Tanzania

Nance, N.; S. Mc Coy, D. Ngilanwa, et al. (2017) C1

Impact Evalution Report 61

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Home visits versus fixed-site care by community health workers and child survival: a cluster-randomized trial, Mali

World Health Organisation (WHO) (2024) C_WHO

Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies, hinder progress in further reducing morbidity and m... more

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INTEGRATING MICROFINANCE AND COMMUNITY HEALTH INTERVENTIONS: A NARRATIVE REVIEW OF EVIDENCES FROM INDIA

Sheila Leatherman, Somen Saha, Marcia Metcalfe, et al. International Journal of Development Research (2014) C1

Community Assessment For Public Health Emergency Response (Casper) Toolkit; third edition 3.2 recommended

Community Assessment For Public Health Emergency Response (Casper) Toolkit; third edition 3.2
recommended