Effectiveness of Community Health Workers (chws) in the Provision of Basic Preventive and Curative Maternal, Newborn and Child Health (mnch) Interventions: a Systematic Review
Year: 2009
Type: review
Study design: Systematic Review
Abstract: Due to a shortage of health workers, many low income countries rely on\ncommunity health workers (CHWs) for the provision of a wide range of\nprimary health care services, both curative and preventive, including\nmaternal newborn and child health (MNCH) interventions. Several\nsystematic reviews have analysed the contribution of CHWs although none\nhas specifically focused on their role in relation to MNCH. This review\nwas designed to find evidence of the effectiveness of CHWs in providing\nbasic preventive and curative MNCH interventions, and to identify the\nfactors that are crucial to their performance. It was restricted to\narticles published from 1998-2008 in the English language. It included\nstudies with qualitative and quantitative designs. Six electronic\ndatabases were searched and data was extracted using a pretested data\nextraction form designed basing on the Centre for Reviews and\nDissemination (CRD) guidelines (2008). A narrative synthesis approach\nwas used. The quality of included studies was assessed using pretested\nvalidity assessment tools and the applicability of interventions was\nevaluated using the RE-AIM framework. After the filtering, 14 studies\nwere critically appraised, and the majority (12/14) demonstrated that\nCHWs were effective at reducing neonatal/child mortality rates;\npromoting breastfeeding practices; increasing sulfadoxine-pyrimethamine\n(SP) coverage for intermittent preventive treatment of malaria in\npregnancy (IPTp); they provided depot medroxy-progesterone acetate\n(DMPA) injections as safely as qualified staff; and treated malaria in\nchildren effectively, thereby reducing workload of health professionals\nat peripheral health facilities. Crucial factors to their performance\nincluded training, remuneration, inadequate medical supplies, and lack\nof career development structure. The review shows that CHWs can be\neffective at providing basic curative and preventive MNCH\ninterventions. Developing country health systems can make use of this\navailable resource to increase access of MNCH interventions.
Author: June Patrick Bigirwa
Institution: Uganda Martyrs University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1637019647