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Co-design, implementation, and evaluation of a ‘learning from excellence’ intervention for community health workers in Neno District, Malawi
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Kletter, Maartje (2021) Co-design, implementation, and evaluation of a ‘learning from excellence’ intervention for community health workers in Neno District, Malawi. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3766399
Abstract
Background: Community Health Workers (CHWs) provide promotional, preventive, and curative care and link communities to health services. CHW programmes are often hampered by varying performance and poor motivation when brought to scale. Amongst others, CHW motivation could be affected by incentives. This research focuses on a non-financial incentive, Learning from Excellence (LfE), for CHWs in Neno District, Malawi.
Aim: To co-design, implement, and subsequently evaluate a LfE intervention for CHWs, together with CHWs and other stakeholders in Neno District, Malawi.
Methods: Four studies were performed: 1) a systematic review aimed at developing a logic model explaining how interventions like LfE can impact health workers in any setting, 2) a qualitative observational study, aimed at refining the developed logic model to incorporate specific contexts, mechanisms, and outcomes for CHWs in Neno District 3) the co-design, implementation, and roll-out of the LfE intervention, and 4) a mixed method evaluation aimed at examining and explaining the observed impact of LfE on CHWs in Neno District.
Results: A logic model, containing various contextual factors, mechanisms, and outcomes of interventions like LfE was developed in the systematic review. In the observational study, this logic model was adapted based on identified contexts, mechanisms, and outcomes in Neno District. The LfE intervention was subsequently co-designed with stakeholders, piloted to obtain feedback from CHWs, and rolled out in August 2020. In the first three months 555 reports were submitted by CHWs. After the mixed method evaluation, the logic model was adapted to explain the underlying mechanisms leading to impact of LfE on CHWs in Neno District, Malawi.
Conclusion: Various barriers and enablers for the uptake and impact of the LfE intervention were identified and integrated into a logic model, which can be used by those who are interested in designing and/or implementing an LfE intervention for health workers.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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Library of Congress Subject Headings (LCSH): | Community health aides -- Malawi, Community health services -- Malawi, Community health aides -- Malawi -- Evaluation, Community health services -- Malawi -- Evaluation, Medical care -- Quality control | ||||
Official Date: | September 2021 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Brown, Celia A. ; Harris, Bronwyn | ||||
Sponsors: | National Institute for Health Research (Great Britain) | ||||
Format of File: | |||||
Extent: | xvii, 286 leaves : illustrations | ||||
Language: | eng |
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