02175nas a2200193   4500000000100000008004100001260003400042653005700076653002100133653002800154100001200182700001500194700001500209700001400224245015400238856011000392520145400502022002501956       2022                            d  bOxford University Press (OUP)10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aHealth (social science)1 aOlude O1 aVlassoff C1 aNiyikora J1 aKrentel A00aA systematic review of participatory approaches to empower health workers in low- and middle-income countries, highlighting Health Workers for Change  uhttps://academic.oup.com/inthealth/advance-article-pdf/doi/10.1093/inthealth/ihac070/46879974/ihac070.pdf3 a<p>This systematic review assesses participatory approaches to motivating positive change among health workers in low- and middle-income countries (LMICs). The mistreatment of clients at health centres has been extensively documented, causing stress among clients, health complications and even avoidance of health centres altogether. Health workers, too, face challenges, including medicine shortages, task shifting, inadequate training and a lack of managerial support. Solutions are urgently needed to realise global commitments to quality primary healthcare, country ownership and universal health coverage. This review searched 1243 titles and abstracts, of which 32 were extracted for full text review using a published critical assessment tool. Eight papers were retained for final review, all using a single methodology, ‘Health Workers for Change’ (HWFC). The intervention was adapted to diverse geographical and health settings. Nine indicators from the included studies were assessed, eliciting many common findings and documenting an overall positive impact of the HWFC approach. Health workers acknowledged their negative behaviour towards clients, often as a way of coping with their own unmet needs. In most settings they developed action plans to address these issues. Recommendations are made on mainstreaming HWFC into health systems in LMICs and its potential application to alleviating stress and burnout from COVID-19.</p>
  a1876-3413, 1876-3405