Social Determinants of Health Discussion Paper 1 (Debates). This paper was prepared for the launch of the Commission on Social Determinants of Health (CSDH) by its secretariat based at WHO in Geneva. It was discussed by the Commissioners and then revised considering their input.
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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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 ...how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub...erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stake- holders. It recommends a combination of measures aimed at reducing the risk of TB transmission within populations. The emphasis is on early and rapid diagnosis, and proper mana...gement of TB patients.
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Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance
To examine how health aid is spent and channelled, including the distribution of resources across countries and between
subsectors. Our aim was to complement the many qualitative critiques of health aid with a quantitative review and to provide insights on the level of development assistance availa...ble to recipient countries to address their health and health development needs.
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Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute
both to a better quality of life and also to global peace a...nd security
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This module has been developed to provide training and guidance to improve the quality of care and human rights conditions in inpatient, outpatient and community based mental health and related services, following the conduct of a comprehensive assessment using the WHO QualityRights assessment toolk...it.
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he global architecture for providing development assistance for health (DAH)
has become increasing complex in the last decade, with many new funding agencies entering the health sector.
This study presents a detailed picture of European Union (EU) and EU member state originating DAH
between 2006 ...and 2009; with a sp
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This document has been developed to provide training and guidance on how to integrate a human rights approach in mental health and related areas, based on international human rights instruments, in particular the UN Convention on the Rights of Persons with Disabilities (CRPD).
This document has been developed to support countries develop and strengthen individualized peer support services in mental health and related areas. It addresses the provision of individualized peer support in the context of health services and the wider community.
Q1: What are the effective maternal mental health interventions to prevent developmental problems in early infancy?
Implementation guide for national, district and facility levels.
This implementation guide contains practical guidance for policy-makers,
programme managers, health practitioners and other actors working to
establish and implement quality of care (QoC) programmes for maternal,
newborn and child ...health (MNCH) at national, district and facility levels.
It is intended to help anyone, throughout the health system, who wants
to take action to improve the QoC for MNCH.
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