Qualitative assessment of community health workers perspective on their motivation in communitybased primary health care in rural Malawi

International Conference on eHealth Networking, Application and Services

July 04, 2022 | Webinar

Myness Kasanda Ndambo

MPH, Partners in Health, Malawi

Scientific Tracks Abstracts: JCSSB

Abstract :

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 work hard to 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. We utilized an exploratory qualitative study design with focus group discussions 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 purposely selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. 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 challenge 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 positive work environment through supportive relationships between CHWs and supervisors enables the CHWs. This study demonstrated enabling factors and challenges for CHW performance from their perspective within the dualfactor 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 emphasis can shift to enhancing motivational factors found in this study to improve the CHWs' experience in their role.

Biography :

Myness Ndambo is a Public Health specialist and a well experienced qualitative researcher. She holds a Master of Public Health Degree from the College of Medicine. She also holds a Bachelor of Science Degree in Education from the Mzuzu University majoring in Biology and minoring in Statistics. Myness has spent almost her entire career researching on public health challenges affecting the rural population in Malawi. Currently she is working as a Social Scientist at the Malawi Epidemiology and Intervention Research Unit (MEIRU). Before joining MEIRU, she worked as a Research Fellow for Partners in Health where she helped to design and lead a number of studies. Her strong competencies are in qualitative research design, data collection, analysis and dissemination. Her passion is in contributing to finding ways of improving health delivery for the rural poor and vulnerable populations so as to assist them realize their development goa ls.