Work

Quality of local healthcare facilities and deciding on in-facility delivery: identifying contributors to healthcare-seeking behavior among pregnant Malawian women

Year: 2016

Type: article

Abstract: Program/Project Purpose: Access to maternal health services during pregnancy is very low in many low and middle income countries including Malawi, and Community Health Workers (CHWs) are increasingly used to enhance utilization of antenatal care (ANC), delivery, and postnatal care services.In March 2015, Partners In Health in collaboration with the Ministry of Health started the Healthy Mothers, Healthy Communities project which uses CHWs to identify and accompany pregnant women throughout the cascade of perinatal services.We report preliminary findings on the impact of CHWs on utilization of maternal health services in Chifunga Health Center in Neno, Malawi from March to September 2015.Structure/Method/Design: We identified, trained, and supervised 109 CHWs in Chifunga, a rural primary health facility with a catchment area of 10,685 people.CHWs were chosen through a process involving community leaders and members and underwent an 5 day training focusing on maternal health and their role as the link between the community and health system.CHWs were then deployed to households to identify pregnant women, accompany them to health facilities during all antenatal care, labor and delivery, and postnatal care visits.We analyzed the data from the CHW reporting tools and facility registers from March to September 2015.Outcome & Evaluation: In the first 6 months of the project, 1,600 women of childbearing age were screened for pregnancy each month.In total, 201 new pregnancies were identified, of whom 84% were accompanied to their first ANC visit by a CHW.Onehundred sixty pregnant women, both previously and newly pregnant, received at least one home visit per month.At the health facility, 94 women attended ANC each month after the intervention, representing a 53% increase compared to the 3 months preceding the CHW program .The proportion of women starting ANC in their first trimester increased from a baseline of 23% in 2014-2015 to 38% for the first cohort of women that were accompanied to care in March 2015.Going Forward: CHWs in Neno has Played a key role in linking women to perinatal health services .As the program continues we will explore the effect of CHWs on attending a complete package of care for pregnant mothers including all ANC visits, delivery, and postnatal care.

Source: Annals of Global Health

DOI: 10.1016/j.aogh.2016.04.643

Authors: M. Alsan, A. Khan

Institutions: Partners In Health, Stanford University

Language: English

Topic: Global Maternal and Child Health

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,200