Analysis of the quality of seasonal malaria chemoprevention provided by community health Workers in Boulsa health district, Burkina Faso

Abstract Given the high Neo-natal mortality in the state of Uttar Pradesh, India, an emphasis has been given to community health workers (CHW). CHW provides behavior push to pregnant women for utilizing health services, through the strategies of household contact and messaging. However, the disparity in health outcomes and interaction of CHW is profoundly affected by socio-economic determinants; still, the evidence is limited. This study aims to explore socio-economic inequities in quantity and quality of contacts by the CHW and its differential effect on health service utilization. Multistage sampling design identified live births in the last 12 months across the 25 highest-risk districts of Uttar Pradesh(n = 3703). Regression models described the relation between household demographics and CHW contact & specific messaging and interactions of demographics and CHW contact & messaging in predicting health service utilization ( > = 4 antenatal care (ANC) visits, Institutional delivery and 100 iron folic acid (IFA) consumption). No differential likelihood in contact of CHW and specific messaging is found. Further, association of CHW contacts and specific messaging with health outcomes were significantly affected by socio-economic determinants.2 or more contacts along with specific messaging increased the odds of 4+ ANC to a higher degree among illiterate women compared to literate women(AOR:3.39, 95% CI:2.28-5.04 vs AOR:1.44, 95% CI:1.09-1.92). Similarly, the odds of facility delivery increased to a higher degree among lower wealth women compared to higher wealth women (AOR:3.41, 95% CI:2.47-4.71 vs. AOR:1.53, 95% CI: 1.09-2.15). Specific messaging, along with CHW contacts, have a higher magnitude of effects on the marginalized population. This study provides evidence for adjusting implementation strategies based on socio-economic determinants to achieve equitable health service utilization. However, further research on training of CHW on heterogeneous interaction is recommended Key messages There exists differential effects of quantity and quality of contact by community health workers on health service utilization across the different socio-economic strata. Implementation agencies in the LMIC can reduce health inequity by shifting from coverage-oriented target approach towards more prioritized and focused interaction across socio-economic groups.

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Facilitators and Barriers to Uptake of an Extended Seasonal Malaria Chemoprevention Programme in Ghana: A Qualitative Study of Caregivers and Community Health Workers

PLoS ONE ◽

10.1371/journal.pone.0166951 ◽

2016 ◽

Vol 11 (11) ◽

pp. e0166951 ◽

Cited By ~ 5

Author(s):

Gifty D. Antwi ◽

Laura A. Bates ◽

Rebecca King ◽

Princess R. Mahama ◽

Harry Tagbor ◽

...

Keyword(s):

Qualitative Study ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Seasonal Malaria Chemoprevention ◽

Facilitators And Barriers

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Quality of care for severe acute malnutrition delivered by community health workers in southern Bangladesh

Maternal and Child Nutrition ◽

10.1111/j.1740-8709.2012.00409.x ◽

2012 ◽

Vol 9 (1) ◽

pp. 130-142 ◽

Cited By ~ 28

Author(s):

Chloe Puett ◽

Jennifer Coates ◽

Harold Alderman ◽

Kate Sadler

Keyword(s):

Quality Of Care ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Severe Acute Malnutrition ◽

Acute Malnutrition

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Community health workers at the dawn of a new era: 9. CHWs’ relationships with the health system and communities

Health Research Policy and Systems ◽

10.1186/s12961-021-00756-4 ◽

2021 ◽

Vol 19 (S3) ◽

Cited By ~ 6

Author(s):

Karen LeBan ◽

Maryse Kok ◽

Henry B. Perry

Keyword(s):

Health System ◽

Community Health ◽

Community Health Workers ◽

Large Scale ◽

Health Workers ◽

Local Level ◽

Grey Literature ◽

Community Context ◽

New Era

Abstract Background This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major challenge in large-scale CHW programmes is the need for CHWs to establish and maintain beneficial relationships with both sets of actors, who may have different expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities. Methods The authors conducted a selective review of journal articles and the grey literature, including case study findings in the 2020 book Health for the People: National CHW Programs from Afghanistan to Zimbabwe. They also drew upon their experience working with CHW programmes. Results The space where CHWs form relationships with the health system and the community has various inherent strengths and tensions that can enable or constrain the quality of these relationships. Important elements are role clarity for all actors, working referral systems, and functioning supply chains. CHWs need good interpersonal communication skills, good community engagement skills, and the opportunity to participate in community-based organizations. Communities need to have a realistic understanding of the CHW programme, to be involved in a transparent process for selecting CHWs, and to have the opportunity to participate in the CHW programme. Support and interaction between CHWs and other health workers are essential, as is positive engagement with community members, groups, and leaders. Conclusion To be successful, large-scale CHW programmes need well-designed, effective support from the health system, productive interactions between CHWs and health system staff, and support and engagement of the community. This requires health sector leadership from national to local levels, support from local government, and partnerships with community organizations. Large-scale CHW programmes should be designed to enable local flexibility in adjusting to the local community context.

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Experiences of midwives and community health workers using mHealth to improve services to pregnant women in rural Burkina Faso, Africa

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n3p57 ◽

2019 ◽

Vol 10 (3) ◽

pp. 57

Author(s):

Antonia LDC Arnaert ◽

Norma Ponzoni ◽

Zoumanan Debe ◽

Mouoboum Marc Meda ◽

Noufou Gustave Nana ◽

...

Keyword(s):

Burkina Faso ◽

Pregnant Women ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Community Health Center ◽

Structured Interviews ◽

Center Staff ◽

Work Related ◽

Qualitative Descriptive

Objective: This qualitative, descriptive study explored the experiences of midwives and community health workers (CHWs) using mhealth to improve the care provided to pregnant women living in the rural Diapangou region of Burkina Faso, Africa.Methods: Semi-structured interviews were conducted with 4 CHWs and 4 community health center staff. Transcripts were content analyzed.Results: Despite internet connectivity challenges all participants agreed that mhealth allowed them to provide better maternal care. The service enhanced their practice collectively, through facilitating better follow-up care, promoting communication and collaboration, and facilitated management while simplifying administrative tasks. From a managerial perspective, having access to productivity information allowed for effective oversight and supervision of work-related activities. CHWs perceived additional work responsibilities and an opportunity for growth; however, both CHWs and staff recognized that the exposure to technology allowed them to achieve mastery of basic computer skills.Conclusions: The ‘digital divide’ remains a challenge in low resource settings, thus while findings are promising, Burkina Faso will have to wait to reap the full benefits of digital technology until a supportive infrastructure can be put in place.

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Development of a tool for assessing quality of comprehensive care provided by community health workers in a community-based care programme in South Africa

BMJ Open ◽

10.1136/bmjopen-2019-030677 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030677

Author(s):

Frances Griffiths ◽

Olukemi Babalola ◽

Celia Brown ◽

Julia de Kadt ◽

Hlologelo Malatji ◽

...

Keyword(s):

South Africa ◽

Quality Of Care ◽

Community Health ◽

Health Worker ◽

Community Health Workers ◽

Community Health Worker ◽

Health Workers ◽

Comprehensive Care ◽

Household Visit

ObjectiveTo develop a tool for use by non-clinical fieldworkers for assessing the quality of care delivered by community health workers providing comprehensive care in households in low- and middle-income countries.DesignWe determined the content of the tool using multiple sources of information, including interactions with district managers, national training manuals and an exploratory study that included observations of 70 community health workers undertaking 518 household visits collected as part of a wider study. We also reviewed relevant literature, selecting relevant domains and quality markers. To refine the tool and manual we worked with the fieldworkers who had undertaken the observations. We constructed two scores summarising key aspects of care: (1) delivering messages and actions during household visit, and (2) communicating with the household; we also collected contextual data. The fieldworkers used the tool with community health workers in a different area to test feasibility.SettingSouth Africa, where community health workers have been brought into the public health system to address the shortage of healthcare workers and limited access to healthcare. It was embedded in an intervention study to improve quality of community health worker supervision.Primary and secondary outcomesOur primary outcome was the completion of a tool and user manual.ResultsThe tool consists of four sections, completed at different stages during community health worker household visits: before setting out, at entry to a household, during the household visit and after leaving the household. Following tool refinement, we found no problems on field-testing the tool.ConclusionsWe have developed a tool for assessing quality of care delivered by community health workers at home visits, often an unobserved part of their role. The tool was developed for evaluating an intervention but could also be used to support training and management of community health workers.

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Screening and Treating Malaria in Pregnancy by Community Health Workers in Benin, Burkina Faso and Gambia: Profiles, Perceptions and Time Commitments

10.21203/rs.3.rs-40535/v1 ◽

2020 ◽

Author(s):

Laetitia Duval ◽

Elisa Sicuri ◽

Susana Scott ◽

Maminata Traoré ◽

Halidou Tinto ◽

...

Keyword(s):

Burkina Faso ◽

Community Health ◽

Malaria Transmission ◽

Community Health Workers ◽

Health Workers ◽

The Gambia ◽

Malaria In Pregnancy ◽

Community Based Interventions ◽

Community Based ◽

In Pregnancy

Abstract Background To date, there have been few studies on the roles and challenges that community health workers (CHWs) face when encouraging pregnant women to attend health facilities and provide community-based interventions including scheduled screening and treatment (CSST) for malaria. This study investigates the characteristics, daily activities and time commitments of CHWs tasked with delivering CSST as part of a cluster-randomized controlled trial in Benin, Burkina Faso and Gambia. Methods 45 CHWs were interviewed and observed in three rural settings in West Africa, both during and outside the malaria transmission seasons. Results CHWs in all three settings were predominantly male, over 30 years old and relied on farming for income. Most had completed secondary school in Benin (77%) but not in Burkina Faso (33%) or The Gambia (27%). In Benin, most had been in post between 5 to 10 years; in Burkina Faso and The Gambia the majority had been CHWs for over 10 years. CHWs in Burkina Faso received the highest monthly financial reward for taking part in the trial (US$40), next was Benin (US$22.60) and finally Gambian CHWs received US$11. While the CHWs welcomed the increased training, knowledge and skills they acquired on screening and treating malaria in pregnancy afforded by the trial, they also expressed concern about the transportation challenges of successful community-based interventions in remote areas. CHW duties were a bigger time commitment in Burkina Faso than Benin. The time committed to CHW activities (trial and non-trial) was longer during than outside the malaria transmission season. Conclusions This study highlights the importance of taking into account the variety of existing CHW responsibilities when designing and implementing evidence-based policy to address malaria in pregnancy. The findings emphasise the need to consider both financial and non-financial factors likely to impact the scale-up and sustainability of interventions beyond trial conditions.

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