Abstract
BackgroundVolunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance.MethodsThe study utilized a quasi-experimental nonequivalent design that examined relevant demographic items and knowledge about maternal and newborn health combined with a comprehensive retrospective birth history of women’s children using oral interviews of women who were exposed to health messages delivered by CHWs and those who were not exposed. The project trained CHWs in three geographically distinct areas.ResultsMean knowledge scores were higher in those women who reported being exposed to the health messages from CHWs, Eburru 32.3 versus 29.2, Kinale 21.8 vs 20.7, Nyakio 26.6 vs 23.8. The number of women delivering under skilled attendance was higher for those mothers who reported exposure to one or more health messages, compared to those who did not. The percentage of facility deliveries for women exposed to health messages by CHWs versus non-exposed was: Eburru 46% versus 19%; Kinale 94% versus 73%: and Nyakio 80% versus 78%.ConclusionThe delivery of health messages by CHWs increased knowledge of maternal and newborn care among women in the local community and encouraged deliveries under skilled attendance.
Highlights
Improving maternal, newborn, and child health is an important priority in sub-Saharan Africa where most births and deaths occur at home
This study examines the effectiveness of a community health workers (CHWs) Project conducted in rural Kenya that sought to promote improved knowledge of maternal and newborn health and to increase deliveries under skilled attendance
Kenya has responded to the shortage by developing The Kenya Community Strategy for Health [9], a strategy that utilizes lay volunteers CHWs as the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers
Summary
Newborn, and child health is an important priority in sub-Saharan Africa where most births and deaths occur at home. Kenya has responded to the shortage by developing The Kenya Community Strategy for Health [9], a strategy that utilizes lay volunteers CHWs as the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. In choosing this approach Kenya builds on evidence that task sharing is both possible and effective in promoting health behaviors at the community level [10,11,12]. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance
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