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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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Inclusion Through Community Based Rehabilitation

LIGHT FOR THE WORLD (2012) C1

Lessons learned in Burkina Faso, Ethiopia & Mozambique 2009 - 2011

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Community based rehabilitation (CBR)

World Health Organization (2012) C_WHO

Q4: Should community based rehabilitation be offered to children with intellectual disabilities?

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'Let pikin bisniss be all men bisniss' : survey community based psychosocial programme War Child Sierra Leone 2005-2006 : research paper

Graaff, D. de , Knocke van der Meulen, D. de War Child (2007) C2

The community based programme aims to address the psychosocial needs of children and youth through helping to rebuild peaceful child- and youth-friendly communities through the use of cultural, creative, recreational, sportive and social activities. Within War Child, the community-based approach is ... 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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Economic Evaluation of Community Based Practitioners In Low-And Middle-Income Countries - A literature review, country case studies and a generalized cost-effectiveness model

global health workforce alliance World Health Organization (2015) C_WHO

Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit... more

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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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Act Toolkit 2.0 - Advocacy for community Treatment

B. Killingo; T. Taro; E. Whyle; et al. ITPC (International Treatment Preparedness Coalition) (2016) C2

Strengthening Community responses to HIv Treatment and Prevention

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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 Empowerment in Health Uganda

Edward O'Neil Jr The Brookings Institution’s International Volunteering and Service Initiative (2009) C1

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

M. SHOWKAT GANI, MAL ABIKA SARKER, BULBUL ASHRAF SIDDIQI, ILIA S MAHMUD,YAMIN TAUSEEF JAHANGIR, SA LLY THEOBALD, HERMEN ORM EL, SALAUDDIN BISWAS , KUHEL FAIZUL ISLAM, SUBORN A CAMELLIA, SABINA F AIZ RASHID Reachout Consortium (2014)

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Community deployment of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine: a field guide

World Health Organization WHO (2024) C_WHO

The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation experiences in eight African countries and targets st... more

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Community led-monitoring guide for key malaria programs for civil society organisations

Civil Society For Malaria Elimination CS4ME (2022) CC

Community led-monitoring is based on the principle that «Nothing that is done for us should be done without us”. The combination of this principle with evidence shows that community-led monitoring is an important driver of improved service delivery and health outcomes that needs to be re-empha... more

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Risk communication and community engagement readiness and response toolkit: ebola disease

World Health Organization WHO (2025) C_WHO

This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers and partners to plan and implement readiness and response activities for Ebola disease outbreaks. The toolkit conta... more

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Community Health Worker Training Curriculum - Facilitator's Guide

Baylor Tingathe Community Outreach Programme Baylor College of Medicine Children’s Foundation Malawi (2016) CC

This curriculum was designed to train newly recruited health care workers (HCW) in the basic knowledge and skills needed to improve different HIV services within the health facility including identification, linkage, retention and support. In addition to HIV basics, the training has supplementary un... more

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Community health workers’ efforts to build health system trust in marginalised communities: a qualitative study from South Africa

Watkins, J:W.; F. Griffiths, and J. Goudge BMJ Open (2021) C1

Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ... more