Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Task-shifting and prioritization: A situational analysis examining the role and experiences of community health workers in Malawi
Human Resources for Health, Volume 12, No. 1, Article 24, Year 2014
Notification
URL copied to clipboard!
Description
Background: As low- and middle-income countries face continued shortages of human resources for health and the double burden of infectious and chronic diseases, there is renewed international interest in the potential for community health workers to assume a growing role in strengthening health systems. A growing list of tasks, some of them complex, is being shifted to community health workers' job descriptions. Health Surveillance Assistants (HSAs) - as the community health worker cadre in Malawi is known - play a vital role in providing essential health services and connecting the community with the formal health care sector. The objective of this study was to understand the performed versus documented roles of the HSAs, to examine how tasks were prioritized, and to understand HSAs' perspectives on their roles and responsibilities.Methods: A situational analysis of the HSA cadre and its contribution to the delivery of health services in Zomba district, Malawi was conducted. Focus groups and interviews were conducted with 70 HSAs. Observations of three HSAs performing duties and work diaries from five HSAs were collected. Lastly, six policy-maker and seven HSA supervisor interviews and a document review were used to further understand the cadre's role and to triangulate collected data.Results: HSAs performed a variety of tasks in addition to those outlined in the job description resulting in issues of overloading, specialization and competing demands existing in the context of task-shifting and prioritization. Not all HSAs were resistant to the expansion of their role despite role confusion and HSAs feeling they lacked adequate training, remuneration and supervision. HSAs also said that increasing workload was making completing their primary duties challenging. Considerations for policy-makers include the division of roles of HSAs in prevention versus curative care; community versus centre-based activities; and the potential specialization of HSAs.Conclusion: This study provides insights into HSAs' perceptions of their work, their expanding role and their willingness to change the scope of their practice. There are clear decision points for policy-makers regarding future direction in policy and planning in order to maximize the cadre's effectiveness in addressing the country's health priorities. © 2014 Smith et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Smith, Sarah
Canada, Toronto
Dignitas International
Australia, Sydney
The University of Sydney School of Public Health
Deveridge, Amber
Canada, Toronto
Dignitas International
Australia, Sydney
The University of Sydney School of Public Health
Berman, Josh
Canada, Toronto
Dignitas International
Negin, Joel
Australia, Sydney
The University of Sydney School of Public Health
Mwambene, Nwaka
Canada, Toronto
Dignitas International
Chingaipe, Elizabeth
Malawi, Lilongwe
Ministry of Health Malawai
Puchalski Ritchie, Lisa M.
Canada, Toronto
University of Toronto
Canada, Toronto
University Health Network
Martiniuk, Alexandra Lynda Conboy
Australia, Sydney
The University of Sydney School of Public Health
Canada, Toronto
University of Toronto
Australia, Sydney
George Institute for Global Health
Statistics
Citations: 113
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1186/1478-4491-12-24
e-ISSN:
14784491
Research Areas
Health System And Policy
Study Locations
Malawi