scholarly journals The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia

2019 ◽  
Vol 4 (4) ◽  
pp. e001388 ◽  
Author(s):  
Abimbola Olaniran ◽  
Barbara Madaj ◽  
Sarah Bar-Zev ◽  
Nynke van den Broek
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Newborn Health ◽  
Skilled Birth Attendance ◽  
Scope Of Practice ◽  
Maternal And Newborn Health ◽  
Birth Attendance ◽  
Maternal And Newborn

IntroductionA variety of community health workers (CHWs) provide maternal and newborn health (MNH) services in low-income and middle-income settings. However, there is a need for a better understanding of the diversity in type of CHW in each setting and responsibility, role, training duration and type of remuneration.MethodsWe identified CHWs providing MNH services in Bangladesh, India, Kenya, Malawi and Nigeria by reviewing 23 policy documents and conducting 36 focus group discussions and 131 key informant interviews. We analysed the data using thematic analysis.ResultsIrrespective of training duration (8 days to 3 years), all CHWs identify pregnant women, provide health education and screen for health conditions that require a referral to a higher level of care. Therapeutic care, antenatal care and skilled birth attendance, and provision of long-acting reversible contraceptives are within the exclusive remit of CHWs with training greater than 3 months. In contrast, community mobilisation and patient tracking are often done by CHWs with training shorter than 3 months. Challenges CHWs face include pressure to provide MNH services beyond their scope of practice during emergencies, and a tendency in some settings to focus CHWs on facility-based roles at the expense of their traditional community-based roles.ConclusionCHWs are well positioned geographically and socially to deliver some aspects of MNH care. However, there is a need to review and revise their scope of practice to reflect the varied duration of training and in-country legislation.

scholarly journals “If there are no female nurses to attend to me, I will just go and deliver at home”: a qualitative study in Garissa, Kenya

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Coralie N’Gbichi ◽  
Abdhalah Kasiira Ziraba ◽  
David Wainaina Wambui ◽  
Pauline Bakibinga ◽  
Isaac Kisiangani ◽  
...  
Keyword(s):  
Health Facility ◽  
Newborn Health ◽  
Skilled Birth Attendance ◽  
Facility Delivery ◽  
Maternal And Newborn Health ◽  
Health Facility Delivery ◽  
Community Members ◽  
Birth Attendance ◽  
Female Nurses ◽  
Maternal And Newborn

Abstract Background The North Eastern region in Kenya experiences challenges in the utilization of maternal and newborn health services. In this region, culture and religion play a major role in influencing healthcare seeking behaviour of the community. This study was conducted to (i) understand key inherent barriers to health facility delivery in the Somali community of North Eastern Kenya and (ii) inform interventions on specific needs of this community. Methods The study was conducted among community members of Garissa sub-County as part of a baseline assessment before the implementation of an intervention package aimed at creating demand and increasing utilization of maternal and newborn services. Focus group discussions and key informant interviews were conducted with clan leaders, Imams, health managers, member of the county assembly, and service users (women and men) in three locations of Garissa sub-County. Data were analysed through content analysis, by coding recurrent themes and pre-established themes. Results Using health facility for delivery was widely acceptable and most respondents acknowledged the advantages and benefits of skilled birth delivery. However, a commonly cited barrier in using health facility delivery was the issue of male nurses and doctors attending to women in labour. According to participants, it is against their culture and thus a key disincentive to using maternity services. Living far from the health facility and lack of a proper and reliable means of transportation was also highlighted as a reason for home delivery. At the health facility level, respondents complained about the poor attitude of health care providers, especially female nurses being disrespectful; and the limited availability of healthcare workers, equipment and supplies. Lack of awareness and information on the importance of skilled birth attendance was also noted. Conclusion To increase health facility delivery, interventions need to offer services that take into consideration the sociocultural aspect of the recipients. Culturally acceptable and sensitive services, and awareness on the benefits of skilled birth attendance among the community members are likely to attract more women to use maternity services and thus reduce adverse maternal and newborn health outcomes.

scholarly journals Utilization, Predictors and Gaps in the Continuum of Care for Maternal and Newborn Health in Ghana

2021 ◽  
Vol 10 (1) ◽  
pp. 43-53
Author(s):  
Juliana Yartey Enos ◽  
Richard Dickson Amoako ◽  
Innocent Kwao Doku
Keyword(s):  
Maternal Health ◽  
Postnatal Care ◽  
Newborn Health ◽  
Skilled Birth Attendance ◽  
Continuum Of Care ◽  
Maternal And Newborn Health ◽  
Birth Attendance ◽  
Full Complement ◽  
Maternal And Newborn ◽  
The Continuum

Background: Continuum-of-care (CoC) throughout pregnancy, childbirth and the postnatal period is essential for the health and survival of mothers and their babies. This study assesses the utilization, predictors, and gaps in the continuum of maternal and newborn health (MNH) services in Eastern Ghana. Methods: A retrospective cross-sectional survey was conducted to assess utilization of MNH services and their determinants in the East Akim Municipality of Ghana. Three hundred and ten (310) mothers aged 15-49 years were sampled from 4 communities (3 rural; 1 urban) in the municipality using stratified sampling methodology. Logistic regression models were fitted to determine the likelihood of utilizing skilled birth attendance (SBA) and postnatal care (PNC) after antenatal care (ANC). Results: Sixty-six percent (66%) of mothers surveyed received the full complement of MNH services (ANC, SBA, PNC) for their most-recent birth. While 98% of mothers made at least one ANC visit with 83.5% receiving the World Health Organization-recommended 4+ visits, only 74% accessed SBA indicating a 24% attrition in the CoC from ANC to SBA, and an 8% attrition from SBA to PNC. About 86% of mothers accessed PNC within 42 days postpartum. Distance to health facility, urban residence, and exposure to media information were strong predictors of the full complement of MNH continuumof- care utilization. Conclusion and Global Health Implications: The study found a remarkable utilization of MNH services in East Akim with significant attrition along the continuum-of-care. Efforts to enhance utilization of the MNH continuum-of-care should focus on increasing access to SBA in particular, through equitable distribution of MNH services in hard-to-reach areas and innovative communication approaches for reducing attrition at each level of the continuum-of-care. Evidence from this study can inform strategies for achieving universal access and utilization of the MNH continuum-of-care towards global goals and improved health outcomes in Ghana and other countries. Key words: • Continuum-of-care • Antenatal care • Skilled birth attendance • Postnatal care • Maternal health services • Maternal health • Newborn health • Ghana Copyright © 2021 Enos et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 367
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí López-Ejeda ◽  
Mamadou Traore ◽  
Adama Balla Coulibaly ◽  
Aly Landouré ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Acute Malnutrition ◽  
Control Group ◽  
Supportive Supervision ◽  
Supervision Group ◽  
Different Levels

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.

Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Providers ◽  
Health Workers ◽  
Healthcare Providers ◽  
Newborn Health ◽  
World Health ◽  
Maternal And Newborn Health ◽  
Care Providers ◽  
Maternal And Newborn

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

scholarly journals Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e021467 ◽  
Author(s):  
James O’Donovan ◽  
Charles O’Donovan ◽  
Isla Kuhn ◽  
Sonia Ehrlich Sachs ◽  
Niall Winters
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Review Of The Literature ◽  
Ongoing Training
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