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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 accompan ... iment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to maintain 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

Guidelines on Implementation of the Antimicrobial Strategy in South Africa: One Health Approach & Governance

Ministerial Advisory Committee on Antimicrobial Resistance National Dept. of Health, South Africa (2017) C2

I1. IACAPAP Textbook of Child and Adolescent Mental Health - Psychiatry and Pediatrics

O. Fiertag; S. Taylor; A. Tareen; E. Garralda IACAPAP (2012) C2

Section I Somatoform disorders Child Psychiatry and Pediatrics Chapter I.1

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 ... more

Transgender HIV/AIDS Health services

TargetHIV (2019) C2

Best Practices Guidelines Accessed: 06.11.2019

Monitoring financial protection and utilization of health services in Mongolia: 2009-2018

World Health Organization, Regional Office for the Western Pacific (2022) C1

Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 2018, despite ambitious ... more

Ethiopia's human resources for health proramme. Country case study

World Health Organization WHO; Global Health Workforce Alliance (2010) CC

GHWA Task Force on Scaling Up Education and Training for Health Workers

Effect of socioeconomic inequalities and vulnerabilities on health-system preparedness and response to COVID-19 in Brazil: a comprehensive analysis

Rocha, R.; et al. (2021) C1

Lancet Glob Health 2021; 9: e782–92

Health Information System Strategic Plan 2008-2015 , accountability, efficiency, quality, equity

Ministry of Health, Cambodia (2008) CC

HEALTH SYSTEMS FINANCING The path to universal coverage

World Health Organization (2010) C_WHO

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 ... more

Bangladesh Health System Review

Asia Pacific Observatory on Health Systems and Policies (2015) C1

Health Systems in Transition. Vol. 5 No.3 2015

National Health Strategic Plan 2011 - 2015

Ministry of Health, Zambia (2011) C1

A Policy Guide for Implementing Essential Interventions for Reproductive, Maternal, Newborn and Child Health (RMNCH)

World Health Organization (2014)

The Compendium brings together for the first time key consensus-based policy recommendations and guidance to improve the delivery of proven interventions to women and children. The user-friendly format incorporates icons and tabs to present key health ... more

Action Plan for advancing young people's health in Nigeria: 2010 ‐ 2012

Federal Ministries of Health & Youth Development, UNFPA (2010) C1

Best Practices in Strengthening Community Health Information Systems

MEASSURE Evaluation PIMA (2016) C1

Nepal: Health Sector Strategy: An Agenda for Reform

Ministry of Health, Government of Nepal (2004) C1

WHO strategic approach on air quality, energy access and health

World Health Organization WHO (2025) C_WHO

WHO, as the coordinating authority on international health, supports countries in protecting public health through evidence-based policies and actions. Considering the significant ... more

National guidance and district-level practices in the supervision of community health workers in South Africa: a qualitative study

Assegaai, T. and H. Schneider Human Resources for Health (2019) C1

Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses th ... more

WHO guideline on health policy and system support to optimize community health worker programmes
recommended

World Health Organization WHO (2018) C_WHO

The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems ... more