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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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India National Health Policy 2017

Ministry of Health and Family Welfare, India (2017) C1

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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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Classification of digital health interventions v1.0. A shared language to describe the uses of digital technology for health

World Health Organization (2018) C_WHO

The classification of digital health interventions (DHIs) categorizes the different ways in which digital and mobile technologies are being used to support health system needs. Historically, the diverse communities working in digital health—including government stakeholders, technologists, clinic... more

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Climate Information For Public Health: A Curriculum For Best Practices

Laurence Cibrelus; Gilma Mantilla International Research Institute for Climate and Society (2011) C1

CIPH Curriculum for Best Practices. Putting Principles to Work

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Toolkit for assessing health-system capacity for crisis management. Assessment Forms

WHO Regional Office for Europe European Commission, Directorate-General for Health and Consumers (DG SANCO) (2012)

Strengthening health-system emergency preparedness.

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Human health and climate change in Pacific island countries

World Health Organization (WHO), Regional Office of the Western Pacific (2015) C_WHO

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Can Community Health Workers Report Accurately on Births and Deaths? Results of Field Assessments in Ethiopia, Malawi and Mali

Silva, R.; A. Amouzou; M. Muno, et al. (2016) CC

PLoS ONE 11(1): e0144662. doi:10.1371/journal.pone.0144662

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National Strategy for Adolescent Health 2017-2030

Ministry of Health and Family Welfare, Government of the People's Republic of Bangladesh (2016) C2

The Ministry of Health and Family Welfare is committed to ensuring the effective implementation of this strategy, which will contribute to the overall wellbeing and health of all adolescent boys and girls of Bangladesh

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Revised WHO classification and treatment of childhood pneumonia at health facilities

World Health Organization (2014)

The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (“pneumonia” which is treated at home with oral amoxicillin and “severe pneumonia” which requires injectable antibiotics) and (B) oral amoxicillin replaces o... more

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National Health Strategic Plan 2011 - 2015

Ministry of Health, Zambia (2011) C1

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Public Health Emergency Operations Center (PHEOC) Legal Framework Guide

African Union; Africa CDC Centres for Disease Control and Prevention (2021) CC

A public health emergency operation center (PHEOC) serves as a hub for better coordinating the preparation, response, and recovery for public health emergencies. A functional PHEOC is critical for the implementation of the International Health Regulations (IHR 2005). The Framework for a Public Healt... more

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Protecting Health from Climate Change Vulnerability And Adaptation Assessment

Peter Berry, Diarmid Campbell-Lendrum, Carlos Corvalan, and Joy Guillemot Pan American Health Organization (2010) CC

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Gender and One Health context analysis for HEAL

Eba, B.; Wieland B., Flintan F., et al. (2020) CC

The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly cost-effective and improves effectiveness of core pu... more

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Annual Health Sector Performance Report 2016/2017

Ministry of Health Uganda (2017) C1

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Strategy for Quality Health infrastructure in Africa 2021-2030 Revised Version

AHVPAHHD Departments African Development Bank Group (2021) CC

The African Development Bank has launched a consultation process with health ministers and other partners as it develops a strategy to drive enhanced access to health services across Africa through 2030. Input from ministers in the Bank’s 54 regional member countries, development partners and c... more

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WHO's Health Emergency Appeal 2024

World Health Organization WHO (2024) C_WHO

In 2024, we need US$1.5 billion to provide live-saving health care to millions of people in emergencies. An alarming combination of conflict, climate-related threats and increasing economic hardship mean an estimated 166 million people require health assistance.

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Strategic Toolkit for Assessing Risks- A comprehensive toolkit for all-hazards health emergency risk assessment

World Health Organization WHO (2021) C_WHO

The Strategic Tool for Assessing Risks (STAR) offers a comprehensive, easy-to-use toolkit and approach to enable national and subnational governments to rapidly conduct a strategic and evidence-based assessment of public health risks for planning and prioritization of health emergency preparedness a... more

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Broader health impacts of vertical responses to COVID-19 in low- and middle-income countries

Tabitha Hrynick, T.; S. Ripoll and S. Carter Social Science in Humanitarian Action (2021) C1

This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ... more

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Analysing and using routine data to monitor the effects of COVID-19 on essential health services: practical guide for national and subnational decision-makers

World Health Organization WHO (2021) C_WHO

14 January 2021 This practical guide can be used to help countries monitor and analyse the impact of COVID-19 on essential health services to inform planning and decision-making. It provides practical recommendations on how to use key performance indicators to analyse changes in access to and deliv... more