Understanding the Complex Drivers of Intrinsic Motivation for Health Workers in Malawi

This report is a nationally representative study in Malawi that employed both qualitative and quantitative data collection methods to assess statistically significant drivers of intrinsic motivation for health workers of every cadre accross the entire health system including public, private for-profit, and faith-based health workers. [adapted from author]

Using Primary Health Care (PHC) Workers and Key Informants for Community Based Detection of Blindness in Children in Southern Malawi

The current study compared the effectiveness of trained health surveillance assistants versus trained volunteer key informants in identifying blind children in southern Malawi. [from abstract]

Primary Health Care in Rural Malawi: A Qualitative Assessment Exploring the Relevance of the Community-Directed Interventions Approach

Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. This study aimed at assessing primary health care in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. [adapted from abstract]

Future Career Plans of Malawian Medical Students: A Cross-Sectional Survey

Qualified doctors in Malawi continue to leave the public sector in order to work or train abroad. This study explored the postgraduate plans of current medical students, and the extent to which this is influenced by their background. [adapted from abstract]

Postgraduate Career Intentions of Medical Students and Recent Graduates in Malawi: A Qualitative Interview Study

The aim of this study was to explore the factors influencing the career plans of medical students and recent graduates with regard to four policy-relevant aspects: emigration outside Malawi; working at district level; private sector employment and postgraduate specialisation. [from abstract]

Building a National Model for Knowledge Exchange in Malawi: Findings From a Health Information Needs Assessment

This health information needs assessment, conducted in the capital city and 3 districts of Malawi from July 2009 to September 2009, aimed to determine access to, and need for, health information by health workers in HIV/AIDS and family planning/reproductive health at all levels of the health system. [adapted from abstract]

Involving Expert Patients in Antiretroviral Treatment Provision in a Tertiary Referral Hospital HIV Clinic in Malawi

This article describes a task shifing intervention in Malawi where a cadre of expert patients was trained to assist with some of the clinical tasks of antiretroviral (ART) services as a way to fill the gap in the availability of health workers. [adapted from author]

Who is Doing What? Performance of the Emergency Obstetric Signal Functions by Non-Physician Clinicians and Nurse-Midwives in Malawi, Mozambique, and Tanzania

This policy brief explores actual performance of emergency obstetric care (EmOC) and other related maternal and newborn health services by Nurses, nurse-midwives, and non-physician clinicians who provided at least one of the EmOC signal functions in the previous three months preceding data collection in hospitals and health centres throughout Malawi, Mozambique, and Tanzania. [adapted from author]

Promising Retention Practices of the Christian Health Association of Malawi

In order to explain the Christian Health Association of Malawi’a (CHAM) approaches to HRH, this paper gives an overview of CHAM especially its operational structure; reviews HRH data from affiliated institutions; looks at elements faced by CHAM with regards to retention; and analyzes what CHAM has done to promote retention of health workers. [adapted from author]

Evaluating a Streamlined Clinical Tool and Educational Outreach Intervention for Health Care Workers in Malawi: The PALM PLUS Case Study

This research evaluated the PALM PLUS (Practical Approach to Lung Health and HIV/AIDS in Malawi), a training and job-aid intervention designed to simplify and integrate existing Malawian national guidelines into a single, simple, user-friendly guideline for mid-level health care workers. [from abstract]

Nurses Needed: Partnering to Scale Up Health Worker Education in Malawi

Verah Nkosi, a nursing-midwifery student at the Kamuzu College of Nursing in Malawi, shares her perspective and illustrates some common challenges for increasing the quantity and quality of graduates from health professional schools. [from author]

Valuing Health Workers: Implementing Sustainable Interventions to Improve Health Worker Motivation

The focus of this study has been to identify the most common causes for the health worker high attrition rate and poor motivation within the health sector, and look at the various solutions that are possible. It brings together the findings of many relevant studies by other authors and identifies the most common reasons for high attrition rates. [adapted from summary]

Reproductive Health Services in Malawi: An Evaluation of a Quality Improvement Intervention

The objective of this study was to evaluate the impact of a quality improvement initiative for reproductive health providers on service qualtiy and related outcomes. [adapted from abstract]

Positive Spill-Over Effects of ART Scale Up on Wider Health Systems Development: Evidence from Ethiopia and Malawi

The impact of HIV-specific funds and programmes on non-HIV-related health services and health systems in genera has been debated extensively. Drawing on evidence from Malawi and Ethiopia, this article analyses the effects of ART scale-up interventions on human resources policies, service delivery and general health outcomes, and explores how synergies can be maximized. [from abstract]

Constraints to Implementing the Essential Health Package in Malawi

The research detailed in this paper aimed to understand which health system factors constrained the delivery of the Essential Health Package (EHP) in Malawi, namely two areas factors - human resources and drug supply. [adapted from author]

From PALSA PLUS to PALM PLUS: Adapting and Developing a South African Guideline and Training Intervention to Better Integrate HIV/AIDS Care with Primary Care in Rural Health Centers in Malawi

This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. [from abstract]

Perceptions of Per Diem in the Health Sector: Evidence and Implications

This study details the perceived benefits, problems, and risks of abuse of per diems and allowances in developing countries. Drawing on 41 interviews with government and nongovernmental officials in Malawi and Uganda the report highlights how practices to maximize per diems have become a defining characteristic of many public institutions and influence how employees carry out their work. As per diems have become de facto top ups of salaries, more fundamental reform of health worker incentives and payment is also needed. [from abstract]

No Excuse: Reducing Pressure on HIV Services By Task-Shifting

In Malawi, Doctors without Borders is working with the local health system to shift responsibilities from doctors to nurses and lay workers in order to reduce pressure on qualified health staff. This video, part of a 5-clip series, demonstrates tools and models that could help make improved treatment accessible to many more. [from publisher]

Outcome Assessment of a Dedicated HIV Positive Health Care Worker Clinic at a Central Hospital in Malawi: a Retrospective Observational Study

This study evaluates outcomes of a dedicated health care worker HIV clinic in Malawi against the perceptions, levels of awareness and barriers for uptake to care for health care workers attending the general HIV clinic. [from abstract]

High Rates of Burnout among Health Staff at a Referral Hospital in Malawi: a Cross-Sectional Study

The aims of the study were to examine the prevalence and degree of burnout reported by healthcare workers who provide antenatal, intrapartum, and postnatal services in a district referral hospital in Malawi; and, to explore factors that may influence the level of burnout healthcare workers experience. [from abstract]

Caring for Caregivers: Lessons Learned in Addressing the Needs of Health-Care Workers Affected by HIV/AIDS

This article shares experiences and insights gained, primarily in Zambia but also in Malawi, from the implementation of the “Caring for Caregivers” projects in Zambia and Malawi. [from author]

Peer Group Intervention Reduces Personal HIV Risk for Malawian Health Workers

This study aimed to test a peer group intervention to address personal HIV prevention needs of rural health workers in Malawi. [from abstract]

Evaluation of Malawi's Emergency Human Resources Programme

This is an independent evaluation of the six-year Emergency Human Resource Programme, which was designed to address the health crisis in Malawi largely caused by an acute shortage of professional workers in the public health sector. Central to this commitment was the need to improve staffing levels and increase the production of health workers through a coherent package of financial incentives and investments in local health training institutions. [from summary]

Preservice Education Family Planning Reference Guide

This guide was developed to assist preservice health institutions in Malawi in creating, updating, or adapting the family planning content of their curricula and individual courses. Included in this document are materials that institutions and individual tutors can use to develop technically accurate and pedagogically sound lessons on family planning. [adapted from introduction]

Health Workforce Responses to Global Health Initiatives Funding: a Comparison of Malawi and Zambia

Shortages of health workers are obstacles to utilising global health initiative (GHI) funds effectively in Africa. This paper reports and analyses two countries’ health workforce responses during a period of large increases in GHI funds. [from abstract]

HRH Country Profiles

The HRH country profiles serve as a tool for systematically presenting the HRH situation, policies and management. They are expected to help to monitor trends, generate regional HRH overviews, provide comparable data between countries and identify points for focused action in countries. They will also serve for a comparison of countries’ responses to similar HRH challenges.

Africa's Deadly Brain Drain - Malawi

Africa is in the grip of a medical crisis because its doctors are being lured away by lucrative jobs in Europe. This video reviews the situation in Malawi, which now only has one doctor for every 50,000 people. [from author]

Task Shifting Routine Inpatient Pediatric HIV Testing Improves Program Outcomes in Urban Malawi: A Retrospective Observational Study

This study evaluated two models of routine HIV testing of hospitalized children in a high HIV-prevalence resource-constrained African setting. Both models incorporated task shifting, or the allocation of tasks to the least-costly, capable health worker. [from abstract]

Malawi: Distribution of DMPA at the Community Level: Lessons Learned

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

Community-Based Distribution of Injectable Contraceptives in Malawi

This report presents research findings on the potential for making contraceptives, and in particular injectable contraceptives, widely available through using a community-based distribution approach which would expand the cadre of providers authorized to provide contraceptives to include health surveillance assistants and community-based distribution agents. [adapted from summary]