Implementation research on community health workers’ provision of maternal and child health services in rural Liberia
Luckow, Peter W
Ly, E John
Sechler, Gerald A
Kraemer, John D
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CitationLuckow, P. W., A. Kenny, E. White, M. Ballard, L. Dorr, K. Erlandson, B. Grant, et al. 2017. “Implementation research on community health workers’ provision of maternal and child health services in rural Liberia.” Bulletin of the World Health Organization 95 (2): 113-120. doi:10.2471/BLT.16.175513. http://dx.doi.org/10.2471/BLT.16.175513.
AbstractAbstract Objective: To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods: The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings: Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion: We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:32072009
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