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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Why a 4°C warmer world must be avoided
Trop. Med. Infect. Dis. 2018, 3, 72;
The study identified some key determinants of untimely and incomplete childhood vaccinations in the context of Bangladesh. The findings will contribute to the improvement of age-specific vaccination and support policy makers in taking the necessary control ...strategies with respect to delayed and early vaccination in Bangladesh.
https://doi.org/10.3390/tropicalmed3030072
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Phil. Trans. R. Soc. B (2010) 365, 2959–2971; doi:10.1098/rstb.2010.0143.
Agricultural ecosystems provide humans with food, forage, bioenergy and pharmaceuticals and are essential to human wellbeing. These systems rely on ecosystem services provided by natural ecosystems, including pollination, b...iological pest control, maintenance of soil structure and fertility, nutrient cycling and hydrological services. Preliminary assessments indicate that the value of these ecosystem services to agriculture is enormous and often underappreciated. Agroecosystems also produce a variety of ecosystem services, such as regulation of soil and water quality, carbon sequestration, support for biodiversity and cultural services. Depending on management practices, agriculture can also be the source of numerous disservices, including loss of wildlife habitat, nutrient runoff, sedimentation of waterways, greenhouse gas emissions, and pesticide poisoning of humans and non-target species. The tradeoffs that may occur between provisioning services and other ecosystem services and disservices should be evaluated in terms of spatial scale, temporal scale and reversibility. As more effective methods for valuing ecosystem services become available, the potential for ‘win–win’ scenarios increases. Under all scenarios, appropriate agricultural management practices are critical to realizing the benefits of ecosystem services and reducing disservices from agricultural activities.
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Framework of Indictors and Targets
This review of the IFRC support to the Sierra Leone Red Cross Society response to the 2012 cholera outbreak provides ideas and concepts to promote a more coherent and evidence based rationale on how to make more effective use of IFRC global assets to stop, control, mitigate and respond to cholera ep...idemics. No fit and healthy person should die from cholera – that should be the indicator of success.
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Public Health & Primary Care / Research Article
Cogent Medicine (2018), 5: 1430197
Lefebvre et al., Cogent Medicine (2018), 5: 1430197 https://doi.org/10.1080/2331205X.2018.1430197
The ECA, says over 300,000 Africans could lose their lives due to COVID-19. This, as the pandemic continues to impact on the Continent’s struggling economies whose growth is expected to slow down from 3.2 percent to 1.8 percent in a best-case scenario, pushing close to 27 million people into extr...eme poverty.
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Infect Dis Poverty (2021) 10:15.
Real-time polymerase chain reaction (PCR) is a sensitive and specific method for diagnosing schistoso-
miasis. However, this method should be performed in a laboratory, usually located distant from the sample collection
site. Therefore, it is important to have fas...t sampling preservation methods, which allow simple transport prior to DNA
extraction and amplification. The aim of this study was to verify if blood samples applied to filter paper are suitable for
analysis of Schistosoma mansoni DNA by real-time PCR.
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A nationwide survey of a representative sample of health facilities across public health services in all states and regions of Myanmar has been undertaken since 2014 to track Reproductive Health Commodity Security (RHCS) indicators, such as the availability of reproductive health (RH) commodities; t...he supply chain (including cold chain systems); staff training and supervision; availability of guidelines and protocols; information and communication technologies; methods of waste disposal; and user fees. The surveys have also obtained the views of clients about the quality and cost of services through exit interviews. This is the third report for Myanmar, which is an assessment of the situation in 2016.
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Alcohol, medication, tobacco, illegal drugs, addictive behaviour
Second, revised edition with new layout
Juni 2014
Mental health issues are usually given very low priority in health service policies. Although this is changing, African countries are still confronted with so many problems caused by communicable diseases and malnutrition that they have not woken up to the impact of mental disorders. Every country m...ust formulate a mental health policy based on its own social and cultural realities. Such policies must take into account the scope of mental health problems, provide proven and affordable interventions, safeguard patients’ rights, and ensure equity.
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